Cannulated screw tension band versus Kirschner wire tension band for patellar fractures: A systematic review and meta-analysis

Abstract

Objectives: This meta-analysis aimed to systematically compare the clinical outcomes of cannulated screw tension band (CSTB) and Kirschner wire tension band (KWTB) fixation for patellar fractures.

Materials and methods: Comprehensive searches were conducted in the Cochrane Library, Web of Science, PubMed, Embase, and SpringerLink databases for studies published through July 2025. Search terms included “cannulated screw,” “Kirschner wire," “tension band,” and “patellar fracture.” Mean differences (MDs) and odds ratios (ORs) were utilized as pooled effect measures, with 95% confidence intervals (CIs).

Results: Eleven studies involving 1,358 patients with patellar fractures met the inclusion criteria. Meta-analysis revealed no statistically significant differences between the groups in terms of operative time (MD = 4.00; 95% CI –1.82 ~ 9.82; p = 0.18), fracture healing time (MD = 0.08; 95% CI –0.07 ~ 0.22; p = 0.28), or postoperative Visual Analog Scale scores (MD = 0.21; 95% CI –0.74 ~ 1.15; p = 0.67). However, CSTB fixation demonstrated significantly superior postoperative knee range of motion (ROM) (MD = –7.16; 95% CI –9.34 ~ –4.98; p < 0.00001), higher Lysholm scores (MD = –4.80; 95% CI –6.62 ~ –2.99; p < 0.00001), and significantly lower rates of reoperation (OR = 5.14; 95% CI 2.66 ~ 9.93; p < 0.00001) and overall complications (OR = 14.19; 95% CI 4.85 ~ 41.56; p < 0.00001) compared to KWTB.

Conclusion: For patellar fracture fixation, CSTB offers significant advantages over KWTB in terms of postoperative knee ROM, functional outcomes, reoperation rates, and overall complication rates.

* These authors contributed equally to this work.

Citation: Deng ZB, Shan D, Pan F, Cao YJ. Cannulated screw tension band versus Kirschner wire tension band for patellar fractures: A meta-analysis. Jt Dis Relat Surg 2026;37(2):360-371. doi: 10.52312/jdrs.2026.2558.

Z.B.D., D.S., F.P., Y.J.C.: Contributed to conception and design of this study, study selection and data extraction of the finally included studies were done independently assessed the methodological quality of each included study, contributed to preparation of the manuscript. The final version of the article was approved by all the authors.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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