Medial Patellofemoral Ligament Reconstruction is Preferred to Repair or Reefing for First-Time Patellar Dislocation: A Systematic Review and Meta-analysis

Jiang, Jin; Yi, Zhi; Li, Junmin; Liu, Yan; Xia, Yayi; Meng, Wei

doi:10.1007/s43465-022-00770-w

Cited by 5 publications

(3 citation statements)

References 49 publications

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“…This reason was supported by the finding that the strength of remnant ligaments is more weakened than autogenous or allogenous tendon grafts, even though they are repaired. [ 14 , 43 , 47 ] Additionally, the results of this meta-analysis showed that SUCRA percentage showed that MPFL reconstruction had a lower probability of re-dislocation than MPFL repair even though there was no significant difference between MPFL reconstruction and MPFL repair according to odds ratios values. In previous studies, CPR was thought to be one of the best treatments for treating patellar dislocation by strengthening the medial supporting structures and releasing the tight lateral supporting structures.…”

Section: Discussionmentioning

confidence: 86%

Medial patellofemoral ligament reconstruction appears to be a better treatment than repair, proximal realignment, or conservative management for primary patellar dislocation: A network meta-analysis

Yoo,

Huh,

Lee

et al. 2023

Medicine

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Background: The purpose of this study was to compare the functional outcomes and re-dislocation rates of medial patellofemoral ligament (MPFL) reconstruction, MPFL repair, combined proximal realignment (CPR), and conservative management for primary patellar dislocation by conducting a systematic literature search of the available studies. The hypothesis was that MPFL repair and MPFL reconstruction would be better options for treating primary patellar dislocation. Methods: Randomized controlled trials or prospective studies of primary patellar dislocation treated with MPFL reconstruction, MPFL repair, CPR, or conservative management were identified from the MEDLINE, EMBASE, and the Cochrane Library databases through December 31, 2021. A total of 626 patients met the prespecified inclusion criteria. The methodological quality of each study was assessed using a risk of bias table, Detsky quality index, and Newcastle-Ottawa Scale. The end-point data collected included comparisons of the mean in functional scores on knee outcomes scales and the number of patients who experienced re-dislocation. A network meta-analysis of the relevant literature was performed to investigate which treatment showed better outcomes. Results: In total, 10 trials were included in this study. There was no statistically significant difference in the subgroup analysis in terms of the functional outcomes among MPFL reconstruction, MPFL repair, CPR, and conservative management. However, MPFL reconstruction showed statistically significantly better outcomes than MPFL repair, CPR, or conservative management in terms of the re-dislocation rate. Additionally, surface under the cumulative ranking curve percentage showed that MPFL reconstruction had a lower probability of re-dislocation than MPFL repair even though there was no significant difference (0.24, 95% confidence interval: 0.02–2.91). Conclusion: Using a network meta-analysis, this meta-analysis showed that there was no significant difference in functional outcomes in a subgroup analysis. In re-dislocation subgroup analysis, MPFL repair and MPFL reconstruction produced significantly better results than other treatments. Also, surface under the cumulative ranking curve percentage showed that MPFL reconstruction had a lower probability of re-dislocation than MPFL repair.

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Section: Discussionmentioning

confidence: 86%

Medial patellofemoral ligament reconstruction appears to be a better treatment than repair, proximal realignment, or conservative management for primary patellar dislocation: A network meta-analysis

Yoo,

Huh,

Lee

et al. 2023

Medicine

View full text Add to dashboard Cite

show abstract

“…This is likely why the senior author of the Letter to the Editor chose only to include the Kujala score in their systematic review comparing MPFLR versus repair. 4 While their study did evaluate complications, they found that less than a third of their included studies reported on this, thus highlighting the problem of a lack of reporting of outcomes in the MPFL literature.…”

mentioning

confidence: 99%

Management of Patellar Instability: A Network Meta-analysis of Randomized Control Trials: Response

Hurley,

Anil,

Colasanti

et al. 2024

Am J Sports Med

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“… 10 , 11 , 12 Current treatment options include medial reefing, which has been reported to be 82% effective in avoiding recurrent dislocation but is nonanatomic in young individuals. 13 , 14 Lateral retinacular release may improve patellar stability but also significantly increases the incidence of patellar fracture because it compromises blood flow to the patella. 12 Medial patellofemoral ligament (MPFL) reconstruction is an effective, standard operation for patellar stabilization after recurrent patellar instability but is more complicated in knees after arthroplasty.…”

mentioning

confidence: 99%

Revision Medial Patellofemoral Ligament Reconstruction for Recurrent Instability After Patellofemoral Arthroplasty

Iddir,

Phelan,

Lee

2023

Arthroscopy Techniques

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Medial Patellofemoral Ligament Reconstruction is Preferred to Repair or Reefing for First-Time Patellar Dislocation: A Systematic Review and Meta-analysis

Cited by 5 publications

References 49 publications

Medial patellofemoral ligament reconstruction appears to be a better treatment than repair, proximal realignment, or conservative management for primary patellar dislocation: A network meta-analysis

Medial patellofemoral ligament reconstruction appears to be a better treatment than repair, proximal realignment, or conservative management for primary patellar dislocation: A network meta-analysis

Management of Patellar Instability: A Network Meta-analysis of Randomized Control Trials: Response

Revision Medial Patellofemoral Ligament Reconstruction for Recurrent Instability After Patellofemoral Arthroplasty

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