同种异体移植物重建内侧髌骨稳定结构治疗髌股不稳：叙述性综述
简介
这篇叙述性综述评估了同种异体移植物重建MPFL、MQTFL及MPTL（单独或联合）在成人及骨骼未成熟患者中的应用，现有文献支持其安全有效。患者报告结局与自体移植物重建大体相当，多项同种异体移植物系列中再脱位率相似或略低；在骨骼未成熟患者中，同种异体移植物便于采用保留骺板、无内固定的固定策略，以降低医源性生长障碍风险。联合MPFL与MQTFL重建是初次和翻修中…
英文摘要
Patellofemoral instability is common and disabling, predominantly affecting young and physically active individuals. Reconstruction of the medial soft tissue restraints of the patella has become the cornerstone of surgical management for recurrent patellar dislocation. Allografts offer several advantages over autografts in this setting, including avoidance of donor-site morbidity, shorter operative time, and the flexibility to select graft dimensions without the constraints imposed by patient anatomy. These attributes are particularly relevant when reconstructing the medial patellofemoral ligament (MPFL), the medial quadriceps tendon-femoral ligament (MQTFL), and the medial patellotibial ligament (MPTL), whether in isolation or in combination. This narrative review examines the current evidence on allograft reconstruction of each of these structures in adults and in skeletally immature patients, addressing clinical outcomes, patient-reported outcome measures, complication rates, graft selection principles, surgical technique considerations, and the specific challenges posed by pediatric anatomy. The available literature supports allograft reconstruction of the medial patellar stabilizers as safe and effective. Patient-reported outcome measures are broadly comparable to those achieved with autografts, and re-dislocation rates are similar or modestly lower in several allograft series. In skeletally immature patients, allografts facilitate physeal-sparing and hardware-free fixation strategies that minimize the risk of iatrogenic growth disturbance. Combined MPFL and MQTFL reconstruction using allografts is an emerging and promising technique for both primary and revision settings. Further prospective comparative investigation with longer follow-up is required before definitive recommendations can be made.