The following is a summary of “Medial patellar ligament reconstruction in combination with derotational distal femoral osteotomy for treating recurrent patellar dislocation in the presence of increased femoral anteversion: a systematic review,” published in the April 2024 issue of Surgery by Yang et al.
Medial patellar ligament reconstruction (MPFL-R) paired with derotational distal femoral osteotomy (DDFO) stands as a prevalent surgical approach for addressing recurrent patellar dislocation (RPD) amidst elevated femoral anteversion, representing a cornerstone in contemporary clinical management. Despite its widespread application, a shortage of comprehensive investigations scrutinizing the clinical efficacy of MPFL-R combined with DDFO in managing RPD amid heightened femoral anteversion exists, prompting a meticulous review to elucidate its therapeutic role and outcomes.
In pursuit of this, a systematic review was meticulously conducted in adherence to the PRISMA guidelines, encompassing exhaustive searches across the Medline, Embase, Web of Science, and Cochrane Library databases up to June 1, 2023. Encompassing studies detailing patients who underwent MPFL-R concomitant with DDFO following RPD manifestation alongside increased femoral anteversion were selectively included. Methodological quality evaluation was conducted utilizing the MINORS (Methodological Index for Nonrandomized Studies) score, with comprehensive data extraction and analysis comprising essential facets such as patient demographics, radiological parameters, surgical techniques, patient-reported outcomes, and postoperative complications.
The review encapsulated six pertinent studies encompassing 231 patients (236 knees), predominantly female participants (ranging from 67% to 100%). Noteworthy alterations in femoral anteversion were observed postoperatively, diminishing significantly from 34° preoperatively to 12° postoperatively. Furthermore, analyses of studies revealing preoperative and postoperative outcomes underscored marked enhancements across various clinical scores, including the Lysholm score, Kujala score, International Knee Documentation Committee score, and visual analog scale for pain. Although postoperative complications were documented across all studies, the overall reported complication rate remained modest at 4.7%, with no instances of redislocations reported during follow-up.
In summation, the amalgamation of MPFL-R and DDFO emerges as a favorable therapeutic modality for managing RPD amidst heightened femoral anteversion, evincing promising clinical outcomes and a notable absence of redislocation occurrences. Nonetheless, heterogeneity persists in defining the precise indications for the combined approach, underscoring the imperative for further research endeavors to delineate optimal treatment criteria.
Source: josr-online.biomedcentral.com/articles/10.1186/s13018-024-04709-9
