胫骨结节截骨术治疗髌骨不稳的并发症发生率低且患者报告结局良好：系统综述和Meta分析
简介
一项纳入12项研究、1110例患者（78.0%为女性，各研究平均年龄15.8–27.7岁，平均随访15.0–81.6个月）的系统综述和Meta分析显示，因髌骨不稳定行原发胫骨结节截骨术（TTO）后患者报告结局良好，各研究平均Kujala评分为78.1–96.0，IKDC为83.0–88.4，Lysholm为76.7–94.0；总体并发症发生率为13.4%（1…
英文摘要
PURPOSE: To identify complications in patients who undergo tibial tubercle osteotomy (TTO) for patellar instability and secondarily to summarize patient-reported outcomes across patients who underwent TTO. METHODS: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Embase, and Cochrane Library databases were searched in November 2025 for studies published in the past 20 years. Studies were included if they met these criteria: evaluated complications after primary TTO and were written in English. Data was pooled for analysis using inverse-variance random-effects models. RESULTS: The initial screen identified 5619 studies, 12 of which were included in this systematic review and meta-analysis. A total of 1110 patients were included in this study, with 866 (78.0%) female patients. Mean age across studies ranged from 15.8 to 27.7 years. Mean follow-up times across studies ranged from 15.0 to 81.6 months. Demographics were similar across studies, and each study had a low risk of bias per Methodological Index for Non-Randomized Studies criteria. Favorable postoperative clinical outcomes were observed, with mean Kujala scores of 78.1 to 96.0, International Knee Documentation Committee scores of 83.0 to 88.4, and Lysholm scores of 76.7 to 94.0. Overall, 149 complications were reported from the 1110 patients analyzed (13.4%). Reoperation to remove painful hardware was observed in up to 38.9% (range 0%-38.9%), rates of arthrofibrosis ranged from 0% to 12.5%, postoperative infection rates ranged from 0% to 5.6%, and bony complication rates, including malunion/nonunion and fracture, ranged from 0% to 1% reoperation. The failure-associated reoperation rate ranged from 0% to 25% across studies. CONCLUSIONS: TTO performed for the treatment of patellofemoral instability has low associated bony and soft-tissue complication risk, but it can potentially require reoperation to address hardware-related discomfort, postoperative stiffness, or failure. LEVEL OF EVIDENCE: Level III, systematic review and meta-analysis of Level II and III studies.