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Surgical treatment is better than non-surgical treatment for primary patellar dislocation: a meta-analysis of randomized controlled trials

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

At present, the best treatment for primary patellar dislocation (PPD) has not been unified. Moreover, meta-analyses comparing the non-surgical and surgical treatments of PPD are lacking. Thus, we aimed to compare the clinical efficacy of surgical or non-surgical treatment of PPD.

Methods

Randomized controlled studies of surgical and non-surgical treatments of PPD from 1966 to 2018 were retrieved from the following databases: PubMed, EMBASE, Cochrane Library, Wanfang Database, China Knowledge Network, Google Scholar, and Weipu Database. We screened for literature that met the inclusion criteria and extracted useful data for our meta-analysis.

Results

Nine studies, involving 492 patients, met the inclusion criteria and were analyzed in this study. The recurrence rate of patellar dislocation in the surgical group was lower than that in the non-surgical group (P = 0.04]). Subgroup analysis according to the follow-up time showed that the Kujala score (P < 0.001) and lower recurrence rate of dislocation (P = 0.05) than the non-surgical group in the short term. Subgroup analysis according to surgical year showed that the surgical group get higher Kujala score (P < 0.001) and lower recurrence rate of dislocation (P = 0.01) than the non-surgical group in recent years.

Conclusion

Surgical treatment can provide better clinical results in a short period of time, and patients may achieve good results within 10 years owing to the advances in surgical techniques and instruments. Thus, we recommend surgical treatment as the preferred treatment for primary patellar dislocation.

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Data availability

All the data of the manuscript are presented in the paper.

Abbreviations

PPD:

Primary patellar dislocation

RR:

Relative risk

CI:

Confidence intervals

WMD:

Weighted mean difference

TT-TG distance:

Tibial tuberosity-trochlear groove distance

MPFL:

Medial patellofemoral ligament

SD:

Standard deviation

PEDro scale:

Physiotherapy evidence database scale

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Hangzhou First People’s Hospital, Hangzhou, 310002, China

    Zhengdao Fu, Zhiqiang Zhu, Haitao Chen & Shiqin Zhang

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  1. Zhengdao Fu
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Contributions

ZDF carried out the entire procedure including the literature search and data extraction. He performed the statistical analysis, drafted the manuscript. ZQZ and HTC contributed to the statistical analysis and data extraction. SQZ conceived of the study, coordinated and participated in the entire process of drafting, and revised the manuscript. All authors have contributed significantly. All authors read and approved the final manuscript.

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Correspondence to Shiqin Zhang.

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Fu, Z., Zhu, Z., Chen, H. et al. Surgical treatment is better than non-surgical treatment for primary patellar dislocation: a meta-analysis of randomized controlled trials. Arch Orthop Trauma Surg 140, 219–229 (2020). https://doi.org/10.1007/s00402-019-03308-2

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