Surgical versus non-surgical management for primary patellar dislocations: an up-to-date meta-analysis

详细信息    查看全文

• 作者：Xiaozuo Zheng (1) (2)
  Kai Kang (1) (2)
  Tong Li (1) (2)
  Bo Lu (1) (2)
  Jiangtao Dong (1) (2)
  Shijun Gao (1) (2)
  
• 关键词：Primary patellar dislocation ; Surgery ; Non ; surgical treatment ; Meta ; analysis
• 刊名：European Journal of Orthopaedic Surgery & Traumatology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：24
• 期：8
• 页码：1513-1523
• 全文大小：1,250 KB
• 参考文献：1. Tsai CH, Hsu CJ, Hung CH, Hsu HC (2012) Primary traumatic patellar dislocation. J Orthop Surg Res 7:21 CrossRef
  2. Kepler CK, Bogner EA, Hammoud S, Malcolmson G, Potter HG, Green DW (2011) Zone of injury of the medial patellofemoral ligament after acute patellar dislocation in children and adolescents. Am J Sports Med 39:1444-449 CrossRef
  3. Sillanp?? P, Mattila VM, Iivonen T, Visuri T, Pihlajam?ki H (2008) Incidence and risk factors of acute traumatic primary patellar dislocation. Med Sci Sports Exerc 40:606-11 CrossRef
  4. Colvin AC, West RV (2008) Patellar instability. J Bone Joint Surg Am 90:2751-762 CrossRef
  5. Arendt EA, Fithian DC, Cohen E (2002) Current concepts of lateral patella dislocation. Clin Sports Med 21:499-19 CrossRef
  6. Burks RT, Desio SM, Bachus KN, Tyson L, Springer K (1998) Biomechanical evaluation of lateral patellar dislocations. Am J Knee Surg 11:24-1
  7. Stefancin JJ, Parker RD (2007) First-time traumatic patellar dislocation: a systematic review. Clin Orthop Relat Res 455:93-01 CrossRef
  8. Balcarek P, Jung K, Ammon J et al (2010) Anatomy of lateral patellar instability: trochlear dysplasia and tibial tubercle-trochlear groove distance is more pronounced in women who dislocate the patella. Am J Sports Med 38:2320-327 CrossRef
  9. Beasley LS, Vidal AF (2004) Traumatic patellar dislocation in children and adolescents: treatment update and literature review. Curr Opin Pediatr 16:29-6 CrossRef
  10. Atkin DM, Fithian DC, Marangi KS, Stone ML, Dobson BE, Mendelsohn C (2000) Characteristics of patients with primary acute lateral patellar dislocation and their recovery within the first 6?months of injury. Am J Sports Med 28:472-79
  11. Cash JD, Hughston JC (1988) Treatment of acute patellar dislocation. Am J Sports Med 16:244-49 CrossRef
  12. Panni AS, Vasso M, Cerciello S (2013) Acute patellar dislocation. What to do? Knee Surg Sports Traumatol Arthrosc 21:275-78 CrossRef
  13. Sillanp?? PJ, M?enp?? HM (2012) First-time patellar dislocation: surgery or conservative treatment? Sports Med Arthrosc 20:128-35 CrossRef
  14. M?enp?? H, Huhtala H, Lehto MU (1997) Recurrence after patellar dislocation. Redislocation in 37/75 patients followed for 6-24?years. Acta Orthop Scand 68:424-26 CrossRef
  15. Vainionp?? S, Laasonen E, Silvennoinen T, Vasenius J, Rokkanen P (1990) Acute dislocation of the patella. A prospective review of operative treatment. J Bone Joint Surg Br 72:366-69
  16. Feller JA, Amis AA, Andrish JT, Arendt EA, Erasmus PJ, Powers CM (2007) Surgical biomechanics of the patellofemoral joint. Arthroscopy 23:542-53 CrossRef
  17. Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP (2003) Anatomy and biomechanics of the medial patellofemoral ligament. Knee 10:215-20 CrossRef
  18. Sch?ttle PB, Scheffler SU, Schwarck A, Weiler A (2006) Arthroscopic medial retinacular repair after patellar dislocation with and without underlying trochlear dysplasia: a preliminary report. Arthroscopy 22:1192-198 CrossRef
  19. Sillanp?? PJ, M?enp?? HM, Mattila VM, Visuri T, Pihlajam?ki H (2009) A mi
• 作者单位：Xiaozuo Zheng (1) (2)
  Kai Kang (1) (2)
  Tong Li (1) (2)
  Bo Lu (1) (2)
  Jiangtao Dong (1) (2)
  Shijun Gao (1) (2)
  
  1. Department of Orthopedics, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People’s Republic of China
  2. Orthopaedic Biomechanics Laboratory of Hebei Province, Shijiazhuang, People’s Republic of China
  
• ISSN：1432-1068

文摘

The aim of this up-to-date meta-analysis was to compare the effects of surgical versus non-surgical treatment of patients following primary patellar dislocation and to provide the best evidence currently available. A comprehensive literature search was conducted using multiple databases, including Medline, Embase, and Cochrane Registry of Clinical Trials. All databases were searched from the earliest records to May 2013. Eligible studies were selected, and data were extracted by two independent investigators. The primary outcome variable was the frequency of recurrent patellar dislocation. The other outcomes included knee function scores, patient-rated outcomes, and radiographic examination. If appropriate, meta-analysis of these variables was performed. Nine independent trials were found to match the inclusion criteria. The pooled results demonstrated that the incidence of recurrent patellar dislocation and Hughston visual analog scale was significantly lower in the surgical treatment group than that in the non-surgical treatment group (P?P?>?0.05). This up-to-date meta-analysis indicates that surgical treatment was associated with a lower risk of recurrent patellar dislocation, but a lower Hughston VAS than non-surgical treatment for primary patellar dislocation. More large high-quality trials and further studies are needed to overcome the limitations of small sample sizes, and varieties of different surgical procedures or non-surgical management strategies adopted in the included trials.