Abstract

Purpose

To determine the rate of recurrent dislocation and patellar instability following medial patellofemoral ligament (MPFL) reconstruction with allograft or autograft tissue and compare patient-reported outcomes for patients undergoing allograft and autograft MPFL reconstruction.

Methods

One hundred and fifteen MPFL reconstructions (78 allograft, 37 autograft) without concurrent bony procedures performed between 2008 and 2014 by four sports medicine fellowship-trained orthopedic surgeons at our center were identified. Patient demographics and surgical data were identified by chart review. Chart review and patient interviews were undertaken to identify recurrent patellar dislocations and as recurrent subjective patellofemoral instability. Recurrent dislocation and subjective instability risk were compared between the allograft and autograft groups.

Results

Eighty-seven patients (76%) with complete baseline data and minimum 1-year follow-up were contacted at a mean of 4.1 years following isolated MPFL reconstruction, including 57 patient with allograft reconstructions and 30 with autograft reconstructions. No significant differences in patient sex, age at reconstruction, body mass index, or time to follow-up were noted between groups. Recurrent dislocation occurred in 2 patients in the allograft group (3.5%) and 1 patient in the autograft group (3.3%), (n.s.). Recurrent subjective instability occurred in 17 patients in the allograft group (28.9%) and 11 patients in the autograft group (36.7%), (n.s.). No significant differences in patient-reported outcomes were noted between groups.

Conclusion

The use of either allograft or autograft tissue for MPFL reconstruction results in low (< 3%) risk of recurrent patellar dislocation. Risk of recurrent subjective instability is higher but is similar for both graft types. Surgeons can utilize either graft choice at their discretion without anticipating a significant impact of graft choice on patient outcomes.

Level of evidence

III.

中文翻译：

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同种异体移植与自体移植组织重建pa股韧带导致类似的复发性脱位风险和患者报告的结局。

摘要

目的

确定同种异体或自体组织重建pa股内侧韧带（MPFL）后的复发性脱位和pa骨不稳的比率，并比较同种异体和自体MPFL重建患者的患者报告结局。

方法

确定了在2008年至2014年之间由我们中心的四位运动医学研究人员培训的骨科医生进行的115例MPFL重建术（78例同种异体移植物，37例自体移植物）。通过图表审查确定患者的人口统计学和手术数据。进行图表复查和患者访谈以识别复发性pa骨脱位和复发性主观pa股不稳定。比较同种异体移植和自体移植组的复发性脱位和主观不稳定性风险。

结果

孤立的MPFL重建后平均4.1年，对87例具有完整基线数据和最少1年随访的患者（76％）进行了接触，其中包括57例异体移植重建和30例自体重建重建。两组之间在患者性别，重建年龄，体重指数或随访时间方面无显着差异。同种异体移植组中2例（3.5％）和自体移植组1例（3.3％）复发性脱位（ns）。同种异体移植组中有17例患者复发主观不稳定性（28.9％），同种异体移植组中有11例患者复发（36.7％）（ns）。两组之间患者报告的结局无显着差异。

结论

将同种异体或自体组织用于MPFL重建会导致results骨复发的风险较低（<3％）。复发性主观不稳定性的风险较高，但两种移植物类型相似。外科医生可以自行决定采用哪种移植物选择方法，而无需预期移植物选择对患者预后的重大影响。

证据水平

三，