Does surgical treatment produce better outcomes than conservative treatment for acute primary patellar dislocations? A meta-analysis of 10 randomized controlled trials
Abstract Purpose The objective of this study was to conduct the latest meta-analysis of randomized controlled trials (RCTs) that compare clinical results between surgery and conservative therapy of acute primary patellar dislocation (APPD), focusing on medial patellofemoral ligament (MPFL) reconstru...
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| Format: | Article |
| Language: | English |
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BMC
2020-03-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01634-5 |
| _version_ | 1811187411139428352 |
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| author | Xuewu Xing Hongyu Shi Shiqing Feng |
| author_facet | Xuewu Xing Hongyu Shi Shiqing Feng |
| author_sort | Xuewu Xing |
| collection | DOAJ |
| description | Abstract Purpose The objective of this study was to conduct the latest meta-analysis of randomized controlled trials (RCTs) that compare clinical results between surgery and conservative therapy of acute primary patellar dislocation (APPD), focusing on medial patellofemoral ligament (MPFL) reconstruction. Methods We performed a literature search in Embase, The Cochrane Library, PubMed, and Medline to identify RCTs comparing APPD surgical treatment with conservative treatment from the establishment of each database to January 2019. The methodological quality of each RCT was assessed independently by the two authors through the Cochrane Collaboration’s “Risk of Bias” tool. Mean differences of continuous variables and risk ratios of dichotomous variables were computed for the pooled data analyses. The I 2 statistic and the χ 2 test were used to evaluate heterogeneity, with the significance level set at I 2 > 50% or P < 0.10. Results Ten RCTs with a sum of 569 patients (297 receiving surgical treatment and 263 receiving conservative treatment) met the inclusion criteria for meta-analysis. Pooled data analysis showed no statistical difference in the field of subluxation rate, Kujala score, patient satisfaction, and frequency of reoperation between the two groups. Tegner activity score and recurrent dislocation rate in the conservative group were significantly higher than those in the surgically treated group. Conclusions Conservative treatment may produce better outcomes than surgery for APPD in consideration of Tegner activity score. However, in view of limited research available, the interpretation of the discoveries should be cautious. More convincing evidence is required to confirm the effect of MPFL reconstruction. |
| first_indexed | 2024-04-11T14:01:47Z |
| format | Article |
| id | doaj.art-ba9d9210b4d442808c7d5c499732391e |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T14:01:47Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-ba9d9210b4d442808c7d5c499732391e2022-12-22T04:20:06ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-03-011511910.1186/s13018-020-01634-5Does surgical treatment produce better outcomes than conservative treatment for acute primary patellar dislocations? A meta-analysis of 10 randomized controlled trialsXuewu Xing0Hongyu Shi1Shiqing Feng2Department of Orthopaedics, Tianjin First Central Hospital, First Central Clinical College of Tianjin Medical UniversityDepartment of Orthopaedics, Tianjin Medical University General HospitalDepartment of Orthopaedics, Tianjin Medical University General HospitalAbstract Purpose The objective of this study was to conduct the latest meta-analysis of randomized controlled trials (RCTs) that compare clinical results between surgery and conservative therapy of acute primary patellar dislocation (APPD), focusing on medial patellofemoral ligament (MPFL) reconstruction. Methods We performed a literature search in Embase, The Cochrane Library, PubMed, and Medline to identify RCTs comparing APPD surgical treatment with conservative treatment from the establishment of each database to January 2019. The methodological quality of each RCT was assessed independently by the two authors through the Cochrane Collaboration’s “Risk of Bias” tool. Mean differences of continuous variables and risk ratios of dichotomous variables were computed for the pooled data analyses. The I 2 statistic and the χ 2 test were used to evaluate heterogeneity, with the significance level set at I 2 > 50% or P < 0.10. Results Ten RCTs with a sum of 569 patients (297 receiving surgical treatment and 263 receiving conservative treatment) met the inclusion criteria for meta-analysis. Pooled data analysis showed no statistical difference in the field of subluxation rate, Kujala score, patient satisfaction, and frequency of reoperation between the two groups. Tegner activity score and recurrent dislocation rate in the conservative group were significantly higher than those in the surgically treated group. Conclusions Conservative treatment may produce better outcomes than surgery for APPD in consideration of Tegner activity score. However, in view of limited research available, the interpretation of the discoveries should be cautious. More convincing evidence is required to confirm the effect of MPFL reconstruction.http://link.springer.com/article/10.1186/s13018-020-01634-5PatellaDislocationPrimaryAcuteSurgeryConservative |
| spellingShingle | Xuewu Xing Hongyu Shi Shiqing Feng Does surgical treatment produce better outcomes than conservative treatment for acute primary patellar dislocations? A meta-analysis of 10 randomized controlled trials Journal of Orthopaedic Surgery and Research Patella Dislocation Primary Acute Surgery Conservative |
| title | Does surgical treatment produce better outcomes than conservative treatment for acute primary patellar dislocations? A meta-analysis of 10 randomized controlled trials |
| title_full | Does surgical treatment produce better outcomes than conservative treatment for acute primary patellar dislocations? A meta-analysis of 10 randomized controlled trials |
| title_fullStr | Does surgical treatment produce better outcomes than conservative treatment for acute primary patellar dislocations? A meta-analysis of 10 randomized controlled trials |
| title_full_unstemmed | Does surgical treatment produce better outcomes than conservative treatment for acute primary patellar dislocations? A meta-analysis of 10 randomized controlled trials |
| title_short | Does surgical treatment produce better outcomes than conservative treatment for acute primary patellar dislocations? A meta-analysis of 10 randomized controlled trials |
| title_sort | does surgical treatment produce better outcomes than conservative treatment for acute primary patellar dislocations a meta analysis of 10 randomized controlled trials |
| topic | Patella Dislocation Primary Acute Surgery Conservative |
| url | http://link.springer.com/article/10.1186/s13018-020-01634-5 |
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