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Comparing Nonoperative Treatment, MPFL Repair, and MPFL Reconstruction for Patients With Patellar Dislocation: A
Zhongcheng Liu1, Qiong Yi1, Liangzhi He1
1Department of Orthopaedics, Gansu Key Laboratory of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, PR China.
Orthopaedic Journal of Sports Medicine
|October 4, 2021
Summary
Medial patellofemofal ligament (MPFL) reconstruction offers reduced redislocation and better Kujala scores than repair or nonoperative treatment for patellar dislocation, but with a higher complication risk. MPFL repair also reduces redislocation versus nonoperative care.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanical Engineering
Background:
- Patellar dislocation management involves medial patellofemoral ligament (MPFL) reconstruction, MPFL repair, and nonoperative treatment.
- Optimal treatment selection for patellar dislocation remains unclear.
Purpose of the Study:
- To compare the efficacy and safety of MPFL reconstruction, MPFL repair, and nonoperative treatment for patellar dislocation.
- To evaluate MPFL reconstruction versus MPFL repair, MPFL reconstruction versus nonoperative treatment, and MPFL repair versus nonoperative treatment.
Main Methods:
- Systematic review and network meta-analysis of 12 studies (Level of evidence, 3).
- Searched PubMed, Web of Science, Cochrane Library, Embase, CNKI, and Wanfang databases up to December 2020.
- Evaluated outcomes including redislocation rate, revision rate, complications, and Kujala score.
Main Results:
- MPFL reconstruction significantly reduced redislocation and improved Kujala scores compared to MPFL repair and nonoperative treatment.
- MPFL repair showed reduced redislocation rates versus nonoperative treatment, particularly for recurrent dislocations.
- No significant differences in revision rates; nonoperative treatment had the lowest incidence of treatment-related complications.
Conclusions:
- MPFL reconstruction is effective in decreasing recurrent patellar dislocations but carries a higher risk of complications.
- MPFL repair offers benefits over nonoperative treatment for reducing postoperative redislocation, especially in recurrent cases.
- Treatment choice should balance efficacy in reducing dislocation with potential complication risks.
