Filippo Migliorini1, Nicola Maffulli2,3,4, Jörg Eschweiler5, Valentin Quack5, Markus Tingart5, Arne Driessen5. 1. Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074, Aachen, Germany. migliorini.md@gmail.com. 2. Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy. 3. School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, England. 4. Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Queen Mary University of London, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, England. 5. Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074, Aachen, Germany.
Abstract
INTRODUCTION: The role of the lateral retinaculum in patellofemoral instability is still debated. Lateral retinacular release (LRR), has been extensively performed in combination with different surgical procedures, including reconstruction of medio-patellofemoral ligament (MPFL). Despite controversial indications, the results from these studies seem promising. The present study conducts a systematic review about current biomechanical and clinical evidence concerning the role of LRR in combination with MPFL reconstruction. We performed a comprehensive literature research, comparing the outcomes of MPFL reconstruction with and without LRR. MATERIALS AND METHODS: This systematic review was conducted according to the PRISMA guidelines. The literature search was performed in August 2020. All articles describing the outcome of isolated MPFL reconstruction alone or in combination with a LRR in patients with recurrent patellofemoral instability were considered for inclusion. Only articles reporting data on patients with a minimum of 12-month follow-up were included. Only articles reporting quantitative data under the outcomes of interest were included. RESULTS: A total of 63 articles were eligible for this systematic review, including 2131 knees. The mean follow-up was 40.87 ± 24.1 months. All scores of interests improved in favour of the combined group: Kujala + 3.8% (P = 0.01), Lysholm + 4.2% (P = 0.004), Tegner + 0.8 points (P = 0.04), IKDC + 9.8% (P = 0.02). The ROM was comparable between the two groups (P = 0.4). Similarity was found in terms of positivity to the apprehension test (P = 0.05), rate of complications (P = 0.1), re-dislocations (P = 0.8), and revision surgeries (P = 0.1). CONCLUSION: There is no evidence that adding a lateral release impacts positively on the outcome of MPFL reconstruction. LEVEL OF EVIDENCE: IV, Systematic review.
INTRODUCTION: The role of the lateral retinaculum in patellofemoral instability is still debated. Lateral retinacular release (LRR), has been extensively performed in combination with different surgical procedures, including reconstruction of medio-patellofemoral ligament (MPFL). Despite controversial indications, the results from these studies seem promising. The present study conducts a systematic review about current biomechanical and clinical evidence concerning the role of LRR in combination with MPFL reconstruction. We performed a comprehensive literature research, comparing the outcomes of MPFL reconstruction with and without LRR. MATERIALS AND METHODS: This systematic review was conducted according to the PRISMA guidelines. The literature search was performed in August 2020. All articles describing the outcome of isolated MPFL reconstruction alone or in combination with a LRR in patients with recurrent patellofemoral instability were considered for inclusion. Only articles reporting data on patients with a minimum of 12-month follow-up were included. Only articles reporting quantitative data under the outcomes of interest were included. RESULTS: A total of 63 articles were eligible for this systematic review, including 2131 knees. The mean follow-up was 40.87 ± 24.1 months. All scores of interests improved in favour of the combined group: Kujala + 3.8% (P = 0.01), Lysholm + 4.2% (P = 0.004), Tegner + 0.8 points (P = 0.04), IKDC + 9.8% (P = 0.02). The ROM was comparable between the two groups (P = 0.4). Similarity was found in terms of positivity to the apprehension test (P = 0.05), rate of complications (P = 0.1), re-dislocations (P = 0.8), and revision surgeries (P = 0.1). CONCLUSION: There is no evidence that adding a lateral release impacts positively on the outcome of MPFL reconstruction. LEVEL OF EVIDENCE: IV, Systematic review.
Authors: Petri Sillanpää; Ville M Mattila; Tuomo Iivonen; Tuomo Visuri; Harri Pihlajamäki Journal: Med Sci Sports Exerc Date: 2008-04 Impact factor: 5.411
Authors: Michelle C Boling; Darin A Padua; Stephen W Marshall; Kevin Guskiewicz; Scott Pyne; Anthony Beutler Journal: Am J Sports Med Date: 2009-09-24 Impact factor: 6.202
Authors: Paolo Ferrua; Bradley M Kruckeberg; Stefano Pasqualotto; Massimo Berruto; Pietro Randelli; Elizabeth A Arendt Journal: J Orthop Traumatol Date: 2019-03-26
Authors: Ran Schwarzkopf; Jerry Arraut; Mark Kurapatti; Thomas H Christensen; Joshua C Rozell; Vinay K Aggarwal; Kenneth A Egol Journal: Arch Orthop Trauma Surg Date: 2022-02-24 Impact factor: 3.067
Authors: R Ferracini; M Alessio-Mazzola; B Sonzogni; C Stambazzi; C Ursino; I Roato; F Mussano; A Bistolfi; S Furlan; L Godio; D Alotto; M Formica Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-09-10 Impact factor: 4.114
Authors: Chimere O Ezuma; Yining Lu; Ayoosh Pareek; Ryan Wilbur; Aaron J Krych; Brian Forsythe; Christopher L Camp Journal: Arthrosc Sports Med Rehabil Date: 2022-05-24
Authors: Lambert T Li; Steven L Bokshan; Nicholas J Lemme; Edward J Testa; Brett D Owens; Aristides I Cruz Journal: Arthrosc Sports Med Rehabil Date: 2021-07-16
Authors: Nadim Kheir; Giuseppe Salvatore; Alessandra Berton; Umile Giuseppe Longo; Vincenzo Denaro; Ara Nazarian; Alexander Orsi; Jonathan Egan; Amin Mohamadi; Joseph P DeAngelis; Arun J Ramappa Journal: BMC Musculoskelet Disord Date: 2022-02-11 Impact factor: 2.362
Authors: Filippo Migliorini; Emanuela Marsilio; Francesco Cuozzo; Francesco Oliva; Jörg Eschweiler; Frank Hildebrand; Nicola Maffulli Journal: Life (Basel) Date: 2021-12-08