Operative versus conservative treatment for patellar dislocation: a meta-analysis of 7 randomized controlled trials

Biao Cheng, Xing Wu, Heng'an Ge, Ye Qing Sun, Qiang Zhang, Biao Cheng, Xing Wu, Heng'an Ge, Ye Qing Sun, Qiang Zhang

Abstract

Purpose: Patellofemoral pathology is common, and patellofemoral dislocation mainly affects adolescents and young adults. We conducted a meta-analysis exclusively of RCTs to compare the clinical outcomes of patellar dislocation patients managed operatively versus non-operatively.

Methods: After systematic review of electronic databases and websites, a total of 7 RCTs reporting data on 402 subjects were included. The methodological quality of the literature was assessed using the PEDro critical appraisal tool. Mean differences (MDs) and risk ratio (RR) were calculated for the pooled effects. Heterogeneity was assessed using the I2 test.

Results: Data synthesis showed a lower rate of recurrent patellar dislocation post-treatment in patients managed operatively compared to non-operatively (P=0.01).

Conclusion: The results suggest a difference in outcomes between the treatment strategies. However the limited number of studies and high risk of inherent bias indicate that future studies involving more patients in better-designed randomized controlled trials will be required.

Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8011948721221355.

Figures

Figure 1
Figure 1
Flow diagram of study selection.
Figure 2
Figure 2
PEDro critical appraisal score.
Figure 3
Figure 3
Forest plot to assess recurrent dislocation events between two treatment strategies.
Figure 4
Figure 4
Forest plot to assess frequency of recurrent instability/subluxation events between two treatment strategies.
Figure 5
Figure 5
Forest plot to assess Kujala scores between two treatment strategies.
Figure 6
Figure 6
Forest plot to assess patient satisfaction between two treatment strategies.
Figure 7
Figure 7
Forest plot to assess Tegner scores between two treatment strategies.
Figure 8
Figure 8
Forest plot to assess Hughston VAS scores between two treatment strategies.

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Source: PubMed

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