Which Technique Is Better for Treating Patellar Dislocation? A Systematic Review and Meta-analysis.

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomechanical engineering

Background:

• Patellar dislocation is a common knee injury with various treatment options.
• Discrepancies exist regarding the optimal surgical approach for patellar dislocation.
• Medial patellofemoral ligament (MPFL) reconstruction is a key surgical technique.

Purpose of the Study:

• To compare the efficacy of different surgical techniques for patellar dislocation.
• To evaluate outcomes of MPFL reconstruction versus soft tissue realignment.
• To determine the best treatment for improving stability and functional recovery.

Main Methods:

• Systematic review and meta-analysis of eleven clinical studies.
• Searched MEDLINE, Embase, Cochrane, Web of Science, and Scopus databases.
• Assessed clinical outcomes using Kujala and Lysholm scores, with quality assessment.

Main Results:

• No significant difference between conservative and surgical treatment for primary patellar dislocation.
• MPFL reconstruction showed significantly better Kujala and Lysholm scores for recurrent dislocation compared to soft tissue realignment.
• High heterogeneity was noted in some results, necessitating investigation of prediction intervals.

Conclusions:

• MPFL reconstruction is more effective than soft tissue realignment for recurrent patellar dislocation.
• Surgical treatment for primary patellar dislocation showed no advantage over conservative methods.
• Further research is needed to confirm the benefits of double-bundle MPFL reconstruction due to low evidence levels.