Which Technique Is Better for Treating Patellar Dislocation? A Systematic Review and Meta-analysis
To clarify the discrepancy in surgical options and present evidence to treat patellar dislocation by evaluating which of the techniques yields better improvement in stability and functional recovery for patellar dislocation. The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of...
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| Veröffentlicht in: | Arthroscopy 2018-11, Vol.34 (11), p.3082-3093.e1 |
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| creator | Lee, Dong-Yeong Park, Young-Jin Song, Sang-Youn Hwang, Sun-Chul Park, Jin-Sung Kang, Dong-Geun |
| description | To clarify the discrepancy in surgical options and present evidence to treat patellar dislocation by evaluating which of the techniques yields better improvement in stability and functional recovery for patellar dislocation.
The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus electronic databases were searched for relevant articles comparing the outcomes of medial patellofemoral ligament (MPFL) treatment published up until August 2017. Data searching, extraction, analysis, and quality assessment were performed based on The Cochrane Collaboration guidelines. Clinical outcomes were evaluated using various outcome values in various techniques. For results with high heterogeneity, 95% prediction intervals (PIs) were also investigated.
Eleven clinical studies were investigated. In patients with primary patellar dislocation, there were no significant differences in all evaluated outcomes between the conservative and surgical treatment groups. For patients with recurrent patellar dislocation, MPFL reconstruction was associated with a favorable Kujala score (mean difference, −8.91; 95% confidence interval, −14.05 to −3.77; I2 = 94%; 95% PI, −9.64 to −8.1) and Lysholm score (mean difference, –13.51; 95% confidence interval, −21.35 to –5.68; I2 = 96%; 95% PI, −14.86 to −12.16) when compared with soft tissue realignment surgery.
Although surgical treatment of the MPFL for primary patellar dislocation is not superior to conservative treatment in restoring knee function and clinical outcomes, MPFL reconstruction is associated with more favorable clinical outcomes compared with medial soft tissue realignment surgery in patients with recurrent patellar dislocation. Double-bundle MPFL reconstruction seems to provide more favorable outcomes than single-bundle MPFL reconstruction, but this finding should be interpreted with caution because the evidence levels were low and were from only a few studies.
Level III, meta-analysis. |
| doi_str_mv | 10.1016/j.arthro.2018.06.052 |
| format | Article |
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The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus electronic databases were searched for relevant articles comparing the outcomes of medial patellofemoral ligament (MPFL) treatment published up until August 2017. Data searching, extraction, analysis, and quality assessment were performed based on The Cochrane Collaboration guidelines. Clinical outcomes were evaluated using various outcome values in various techniques. For results with high heterogeneity, 95% prediction intervals (PIs) were also investigated.
Eleven clinical studies were investigated. In patients with primary patellar dislocation, there were no significant differences in all evaluated outcomes between the conservative and surgical treatment groups. For patients with recurrent patellar dislocation, MPFL reconstruction was associated with a favorable Kujala score (mean difference, −8.91; 95% confidence interval, −14.05 to −3.77; I2 = 94%; 95% PI, −9.64 to −8.1) and Lysholm score (mean difference, –13.51; 95% confidence interval, −21.35 to –5.68; I2 = 96%; 95% PI, −14.86 to −12.16) when compared with soft tissue realignment surgery.
Although surgical treatment of the MPFL for primary patellar dislocation is not superior to conservative treatment in restoring knee function and clinical outcomes, MPFL reconstruction is associated with more favorable clinical outcomes compared with medial soft tissue realignment surgery in patients with recurrent patellar dislocation. Double-bundle MPFL reconstruction seems to provide more favorable outcomes than single-bundle MPFL reconstruction, but this finding should be interpreted with caution because the evidence levels were low and were from only a few studies.
Level III, meta-analysis.</description><identifier>ISSN: 0749-8063</identifier><identifier>EISSN: 1526-3231</identifier><identifier>DOI: 10.1016/j.arthro.2018.06.052</identifier><identifier>PMID: 30301628</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Conservative Treatment ; Humans ; Ligaments, Articular - surgery ; Orthopedic Procedures - methods ; Patellar Dislocation - surgery ; Patellar Dislocation - therapy ; Patellofemoral Joint - surgery ; Recovery of Function</subject><ispartof>Arthroscopy, 2018-11, Vol.34 (11), p.3082-3093.e1</ispartof><rights>2018 Arthroscopy Association of North America</rights><rights>Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-91ee80086782137ab4401ba9c69f108e92d8b82203b93b683adea25b575249e43</citedby><cites>FETCH-LOGICAL-c362t-91ee80086782137ab4401ba9c69f108e92d8b82203b93b683adea25b575249e43</cites><orcidid>0000-0001-6894-2684</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0749806318305693$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30301628$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Dong-Yeong</creatorcontrib><creatorcontrib>Park, Young-Jin</creatorcontrib><creatorcontrib>Song, Sang-Youn</creatorcontrib><creatorcontrib>Hwang, Sun-Chul</creatorcontrib><creatorcontrib>Park, Jin-Sung</creatorcontrib><creatorcontrib>Kang, Dong-Geun</creatorcontrib><title>Which Technique Is Better for Treating Patellar Dislocation? A Systematic Review and Meta-analysis</title><title>Arthroscopy</title><addtitle>Arthroscopy</addtitle><description>To clarify the discrepancy in surgical options and present evidence to treat patellar dislocation by evaluating which of the techniques yields better improvement in stability and functional recovery for patellar dislocation.
The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus electronic databases were searched for relevant articles comparing the outcomes of medial patellofemoral ligament (MPFL) treatment published up until August 2017. Data searching, extraction, analysis, and quality assessment were performed based on The Cochrane Collaboration guidelines. Clinical outcomes were evaluated using various outcome values in various techniques. For results with high heterogeneity, 95% prediction intervals (PIs) were also investigated.
Eleven clinical studies were investigated. In patients with primary patellar dislocation, there were no significant differences in all evaluated outcomes between the conservative and surgical treatment groups. For patients with recurrent patellar dislocation, MPFL reconstruction was associated with a favorable Kujala score (mean difference, −8.91; 95% confidence interval, −14.05 to −3.77; I2 = 94%; 95% PI, −9.64 to −8.1) and Lysholm score (mean difference, –13.51; 95% confidence interval, −21.35 to –5.68; I2 = 96%; 95% PI, −14.86 to −12.16) when compared with soft tissue realignment surgery.
Although surgical treatment of the MPFL for primary patellar dislocation is not superior to conservative treatment in restoring knee function and clinical outcomes, MPFL reconstruction is associated with more favorable clinical outcomes compared with medial soft tissue realignment surgery in patients with recurrent patellar dislocation. Double-bundle MPFL reconstruction seems to provide more favorable outcomes than single-bundle MPFL reconstruction, but this finding should be interpreted with caution because the evidence levels were low and were from only a few studies.
Level III, meta-analysis.</description><subject>Conservative Treatment</subject><subject>Humans</subject><subject>Ligaments, Articular - surgery</subject><subject>Orthopedic Procedures - methods</subject><subject>Patellar Dislocation - surgery</subject><subject>Patellar Dislocation - therapy</subject><subject>Patellofemoral Joint - surgery</subject><subject>Recovery of Function</subject><issn>0749-8063</issn><issn>1526-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOwzAQRS0EgvL4A4S8ZJMwthPX2YB4gwQCQRFLy3Gm1FWagO2C-ve4KrBkNZrRnTtzDyH7DHIGTB5Nc-PjxPc5B6ZykDmUfI0MWMllJrhg62QAw6LKFEixRbZDmAKAEEpski0BIllwNSD168TZCR2hnXTuY470NtAzjBE9Hfeejjya6Lo3-mgitq3x9MKFtrdp2Hcn9JQ-L0LEWWotfcJPh1_UdA29x2gy05l2EVzYJRtj0wbc-6k75OXqcnR-k909XN-en95lVkges4ohKgAlh4ozMTR1UQCrTWVlNWagsOKNqhXnIOpK1FIJ06DhZV0OS15UWIgdcrjyffd9ShKinrlgl1932M-D5owla8ELnqTFSmp9H4LHsX73bmb8QjPQS7p6qld09ZKuBqkT3bR28HNhXs-w-Vv6xZkExysBppyJhtfBOuwsNs6jjbrp3f8XvgGawIxL</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Lee, Dong-Yeong</creator><creator>Park, Young-Jin</creator><creator>Song, Sang-Youn</creator><creator>Hwang, Sun-Chul</creator><creator>Park, Jin-Sung</creator><creator>Kang, Dong-Geun</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6894-2684</orcidid></search><sort><creationdate>201811</creationdate><title>Which Technique Is Better for Treating Patellar Dislocation? A Systematic Review and Meta-analysis</title><author>Lee, Dong-Yeong ; Park, Young-Jin ; Song, Sang-Youn ; Hwang, Sun-Chul ; Park, Jin-Sung ; Kang, Dong-Geun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-91ee80086782137ab4401ba9c69f108e92d8b82203b93b683adea25b575249e43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Conservative Treatment</topic><topic>Humans</topic><topic>Ligaments, Articular - surgery</topic><topic>Orthopedic Procedures - methods</topic><topic>Patellar Dislocation - surgery</topic><topic>Patellar Dislocation - therapy</topic><topic>Patellofemoral Joint - surgery</topic><topic>Recovery of Function</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Dong-Yeong</creatorcontrib><creatorcontrib>Park, Young-Jin</creatorcontrib><creatorcontrib>Song, Sang-Youn</creatorcontrib><creatorcontrib>Hwang, Sun-Chul</creatorcontrib><creatorcontrib>Park, Jin-Sung</creatorcontrib><creatorcontrib>Kang, Dong-Geun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Arthroscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Dong-Yeong</au><au>Park, Young-Jin</au><au>Song, Sang-Youn</au><au>Hwang, Sun-Chul</au><au>Park, Jin-Sung</au><au>Kang, Dong-Geun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Which Technique Is Better for Treating Patellar Dislocation? A Systematic Review and Meta-analysis</atitle><jtitle>Arthroscopy</jtitle><addtitle>Arthroscopy</addtitle><date>2018-11</date><risdate>2018</risdate><volume>34</volume><issue>11</issue><spage>3082</spage><epage>3093.e1</epage><pages>3082-3093.e1</pages><issn>0749-8063</issn><eissn>1526-3231</eissn><abstract>To clarify the discrepancy in surgical options and present evidence to treat patellar dislocation by evaluating which of the techniques yields better improvement in stability and functional recovery for patellar dislocation.
The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus electronic databases were searched for relevant articles comparing the outcomes of medial patellofemoral ligament (MPFL) treatment published up until August 2017. Data searching, extraction, analysis, and quality assessment were performed based on The Cochrane Collaboration guidelines. Clinical outcomes were evaluated using various outcome values in various techniques. For results with high heterogeneity, 95% prediction intervals (PIs) were also investigated.
Eleven clinical studies were investigated. In patients with primary patellar dislocation, there were no significant differences in all evaluated outcomes between the conservative and surgical treatment groups. For patients with recurrent patellar dislocation, MPFL reconstruction was associated with a favorable Kujala score (mean difference, −8.91; 95% confidence interval, −14.05 to −3.77; I2 = 94%; 95% PI, −9.64 to −8.1) and Lysholm score (mean difference, –13.51; 95% confidence interval, −21.35 to –5.68; I2 = 96%; 95% PI, −14.86 to −12.16) when compared with soft tissue realignment surgery.
Although surgical treatment of the MPFL for primary patellar dislocation is not superior to conservative treatment in restoring knee function and clinical outcomes, MPFL reconstruction is associated with more favorable clinical outcomes compared with medial soft tissue realignment surgery in patients with recurrent patellar dislocation. Double-bundle MPFL reconstruction seems to provide more favorable outcomes than single-bundle MPFL reconstruction, but this finding should be interpreted with caution because the evidence levels were low and were from only a few studies.
Level III, meta-analysis.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30301628</pmid><doi>10.1016/j.arthro.2018.06.052</doi><orcidid>https://orcid.org/0000-0001-6894-2684</orcidid></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Conservative Treatment Humans Ligaments, Articular - surgery Orthopedic Procedures - methods Patellar Dislocation - surgery Patellar Dislocation - therapy Patellofemoral Joint - surgery Recovery of Function |
| title | Which Technique Is Better for Treating Patellar Dislocation? A Systematic Review and Meta-analysis |
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