Double-bundle versus single-bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocation:...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• Recurrent patellar dislocation (RPD) significantly impacts knee function and quality of life.
• Medial patellofemoral ligament (MPFL) reconstruction is a common surgical treatment for RPD.
• The optimal surgical technique, single-bundle versus double-bundle MPFL reconstruction, remains debated.

Purpose of the Study:

• To compare the clinical efficacy of single-bundle versus double-bundle MPFL reconstruction for RPD.
• To evaluate differences in knee function scores, postoperative complications, and imaging assessments between the two techniques.
• To determine which surgical approach yields superior outcomes for patients with RPD.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) and cohort studies (CSs) were conducted.
• Databases searched included PubMed, Cochrane Library, Embase, CBM, CNKI, and VIP.
• Study quality was assessed using the Cochrane risk-of-bias tool for RCTs and the Newcastle-Ottawa Scale for CSs. Meta-analysis was performed using RevMan 5.3 and STATA 16.0.

Main Results:

• Thirteen studies (4 RCTs, 9 CSs) involving 862 patients (891 knees) were included.
• Double-bundle MPFL reconstruction showed significantly better Kujala, Tegner, and IKDC scores compared to single-bundle.
• The double-bundle group also demonstrated a significantly lower rate of postoperative recurrent patellar instability (OR=0.12).

Conclusions:

• Double-bundle MPFL reconstruction is superior to single-bundle reconstruction for RPD regarding knee function scores.
• The double-bundle technique significantly reduces the risk of postoperative recurrent patellar instability.
• Double-bundle MPFL reconstruction offers better overall clinical outcomes for patients with recurrent patellar dislocation.