股四头肌腱与腘绳肌腱自体移植物用于内侧髌股韧带重建的比较：系统综述与Meta分析
简介
这项系统综述与Meta分析纳入4项对照研究、共246例接受单纯内侧髌股韧带（MPFL）重建的患者，比较股四头肌腱（QT）与腘绳肌腱（HT）自体移植物：术后Kujala评分、Lysholm评分、Tegner活动评分及疼痛VAS在两组间均无统计学显著差异。两组均未报告复发性髌骨脱位，术后恐惧试验阳性率低且相近；仅1项研究报告了客观肌力，QT组膝伸与膝屈的肢体对称…
英文摘要
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is the primary surgical treatment for recurrent patellofemoral instability. Hamstring tendon (HT) autografts have traditionally been used, while quadriceps tendon (QT) autografts have gained popularity as an alternative. The purpose of this study was to compare clinical, functional, stability, and objective strength outcomes following MPFL reconstruction using QT versus HT autografts. METHODS: PubMed, Scopus, and Ovid MEDLINE were searched. Comparative studies directly evaluating QT and HT autografts for isolated MPFL reconstruction were included. Primary outcome was postoperative Kujala score. Secondary outcomes included Lysholm score, Tegner activity score, pain visual analog scale (VAS), recurrent dislocation, apprehension test, and objective strength measures when available. Meta-analyses were conducted using fixed- or random-effects models based on heterogeneity. RESULTS: Four comparative studies involving 246 patients met inclusion criteria. Meta-analysis demonstrated no statistically significant differences between QT and HT autografts in postoperative Kujala score, Lysholm score, Tegner activity score, or pain VAS. No recurrent patellar dislocations were reported in either group, and the incidence of postoperative apprehension was low and similar. Objective strength outcomes were reported in one study, which showed higher limb symmetry indices for knee extension and flexion in the QT group, while hamstring-to-quadriceps ratios were similar between grafts. CONCLUSION: QT autografts provide comparable patient-reported outcomes and stability to HT autografts for MPFL reconstruction. However, the absence of recurrent dislocations in these cohorts should be interpreted with caution due to the small total sample size and the retrospective nature of the included studies. REGISTRATION: PROSPERO (CRD420261294759).