Conservative versus repair of medial patellofemoral ligament for the treatment of patients with acute primary patellar dislocations: A systematic review and meta-analysis

Abstract

Purpose: The aim of this study was to perform a meta-analysis to compare the effects of repair of medial patellofemoral ligament (MPFL) and conservative treatment in patients with acute primary patellar dislocation (PPD). Method: The databases we used to search the studies included MEDILINE, EMBASE, and Cochrane registry of controlled clinical trials. Five randomized controlled studies comparing the effects of MPFL repair versus conservative treatment with 300 acute PPD patients were included in the present meta-analysis. Primary outcome was redislocation rate and secondary outcomes included Kujala score, percentage of excellent or good subjective opinion, Tegner activity score, and knee injury and osteoarthritis outcome score (KOOS; pain, symptoms, and activities of daily living). Results: The outcome of the Kujala score was statistically significant between the two treatments and indicated that MPFL repair had a higher Kujala score than conservative treatment in patients with acute PPD. There was no significant difference between the two treatments regarding the redislocation rate ( p = 0.32), percentage of excellent or good subjective opinion ( p = 0.15), Tegner activity score ( p = 0.24), and KOOS ( p > 0.05). Conclusions: Based on the available data, MPFL repair did not reduce the risk of redislocation nor did it produce any significantly better outcome based on the clinical manifestations, including anterior knee pain and knee activities. Only the Kujala score was improved by MPFL repair compared with conservative treatment.