Operative versus non-operative management of patellar dislocation. A meta-analysis

Smith, Toby; Song, Fujian; Donell, Simon T.; Hing, Caroline B.

doi:10.1007/s00167-010-1355-2

Cited by 117 publications

(108 citation statements)

References 49 publications

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“…According to a recent meta-analysis, operative treatment is associated with a higher risk of patellofemoral osteoarthritis [16]. The authors concluded that a delay of surgical intervention, allowing recurrent dislocations to cause further chondral damage, might be responsible for the high risk of osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

“…Although it has been shown that operatively treated knees are associated with a lower risk of recurrent dislocations, they may bear a higher risk of subsequent patellofemoral joint degeneration [15,16]. Late osteoarthritis is therefore considered to be an impending risk of this surgical technique due to increased patellofemoral contact pressure and changes of knee joint loading [17][18][19].…”

mentioning

confidence: 99%

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Prevalence of osteoarthritis and clinical results after the Elmslie-Trillat procedure: a retrospective long-term follow-up

Farr

Huyer

Sadoghi

et al. 2013

International Orthopaedics (SICOT)

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Purpose Tibial tuberosity medialisation may be followed by osteoarthritis in the long term due to increased patellofemoral contact pressure and altered knee joint kinematics. We aimed to (1) systematically assess the grades of tibiofemoral and patellofemoral osteoarthritis ten to 30 years after the ElmslieTrillat procedure and (2) to evaluate long-term knee function and activities of daily living. Methods A total of 26 patients (30 knees) were re-evaluated at a minimum follow-up of 12.3 years (mean 20.9±4.1 years). Osteoarthritis was graded according to Kellgren and Lawrence (K/L) and Sperner. All patients were clinically evaluated using the Knee Society Score (KSS) and Knee injury and Osteoarthritis Outcome Score (KOOS). Radiographic data were compared to an age-, sex-and body mass index-matched control group of healthy patients. Results Radiographic evaluation revealed seven cases (23.3 %) with advanced osteoarthritis (K/L and Sperner grades 3 and 4). However, the observed differences from the matched cohort were not statistically significant (P =0.189). A positive correlation was found between the age at index procedure and tibiofemoral osteoarthritis at follow-up (P =0.013). Patient satisfaction was relatively high, showing a mean KSS of 89.9 (knee score) and 94.8 (function score), and a mean KOOS of 78.7. However, we noted four cases of frequent patellar redislocations and three total knee arthroplasties. Conclusions The Elmslie-Trillat procedure was associated with several cases of advanced tibiofemoral and patellofemoral osteoarthritis in the long term, especially if the procedure was performed late. Clinical results were still good to excellent in the majority of patients despite some observed cases of redislocations and decreased ability to perform sports.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Prevalence of osteoarthritis and clinical results after the Elmslie-Trillat procedure: a retrospective long-term follow-up

Farr

Huyer

Sadoghi

et al. 2013

International Orthopaedics (SICOT)

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“…Recurrent patellar dislocation can be caused by both bony and soft tissue abnormalities as highlighted in the abstract [1,2]. It has recently been shown that MCL injuries can co-exist following patellar dislocation.…”

Section: Discussionmentioning

confidence: 99%

Dynamic Valgus Instability of the Knee due to Chronic Medical Collateral Ligament Laxity as a Cause of Recurrent Patella Dislocation

P¹

2015

J Sports Med Doping Stud

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Recurrent patella dislocation can be caused by bony abnormalities, such as patella alta, increased tibial tubercle lateralization, trochlea dysplasia, excessive femoral neck anteversion and external tibial torsion. It can also be caused by soft tissue abnormalities such as a ruptured medial patellofemoral ligament (MPFL) or a weak vastus medialis obliquus. It has been reported in the literature that acute lateral dislocation of the patella can be associated with proximal injury to the medial collateral ligament (MCL).This article reports the case of a 26-year-old male pro footballer who had recurrent patella dislocation related to previous injury to his MPFL and worsened by dynamic valgus knee instability due to chronic MCL insufficiency.

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“…Nonsurgical management in all trials differed and consisted of initial immobilization in a cast or splint for a variable duration of time followed by active mobilization with variable physiotherapy regimens. There is considerable disagreement about the best nonoperative treatment approaches, and further research into identification of an ideal nonoperative management strategy has been previously recommended [8].…”

Section: Upon Closer Inspectionmentioning

confidence: 99%

“…Most techniques generally included repair or reconstruction of the soft tissue structures in the medial aspect of the knee, but specific techniques included MPFL suture repair, medial soft-tissue reefing with MPFL augmentation, combinations with lateral release, and MPFL reconstruction. Another systematic review addressing this topic found that the rationale for undertaking particular techniques rarely were reported despite considerable variability in surgical technique across studies in that review [8]. Additionally, anatomic considerations and diagnostic evaluation of associated conditions such as trochlear hypoplasia or generalized soft-tissue laxity were unreported, which prevents assessment of optimal techniques in specific patient populations.…”

Section: Upon Closer Inspectionmentioning

confidence: 99%

Cochrane in CORR ®: Surgical Versus Non-surgical Interventions for Treating Patellar Dislocation (Review)

Khan

Miller

2016

Clinical Orthopaedics &Amp; Related Research

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Operative versus non-operative management of patellar dislocation. A meta-analysis

Abstract: III.

Cited by 117 publications

References 49 publications

Prevalence of osteoarthritis and clinical results after the Elmslie-Trillat procedure: a retrospective long-term follow-up

Prevalence of osteoarthritis and clinical results after the Elmslie-Trillat procedure: a retrospective long-term follow-up

Dynamic Valgus Instability of the Knee due to Chronic Medical Collateral Ligament Laxity as a Cause of Recurrent Patella Dislocation

Cochrane in CORR ®: Surgical Versus Non-surgical Interventions for Treating Patellar Dislocation (Review)

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