Autograft Medial Patellofemoral Ligament Reconstruction Provides Comparable Patient‐Reported Outcomes and Failure Rates With Fewer Complications Versus Allograft Reconstruction in Adolescent Patients: A Systematic Review
Garrett R. Jackson, Brady Barron, Justin T. Childers, Rhett Wakefield, Sumit Gupta, Clayton Nuelle, Steven F. DeFrodaPurpose
To compare the outcomes, complication profile, and failure rates of medial patellofemoral ligament reconstruction using autograft versus allograft in adolescents.
Methods
A Preferred Reporting Items for Systematic Reviews and Meta‐Analyses‐compliant systematic review of PubMed and Scopus computerized databases identified clinical studies reporting outcomes and complications in patients under 19 years of age who underwent medial patellofemoral ligament reconstruction with at least 2 years of follow‐up. Kujala scores and graft failure rates were collected and separated based on the use of allograft or autograft.
Results
A total of 20 studies (6 allograft cohorts and 16 autograft cohorts), including 596 patients, were included. The mean patient age was 13.9 years (mean range, 10.7‐16.2 years), and the mean follow‐up was 44.1 months (mean range 24‐68.4 months). Mean postoperative Kujala scores ranged from 92.7 to 96.5 in the allograft studies and from 84 to 100 in the autograft studies. The only allograft study that reported pre‐ and postoperative Kujala scores reported a delta of 20.6 points, while the delta of the autograft studies (n = 7 studies) ranged from 19.9 to 74 points. Across the included cohorts, the failure rate ranged from 0% to 26.1% for autografts versus 4.5% to 17% for allografts.
Conclusions
Both autograft and allograft MPFL reconstructions improve patient‐reported outcome measures after patellar dislocation in adolescent patients. Autografts may provide less risk of complications with comparable rates of failure to allograft reconstructions in adolescent patients; however, the inherent heterogeneity of the present study limits any definitive conclusions.
Level of Evidence
Level IV, systematic review of Level II to IV studies.