CC2022: Management of Patellar Instability: A Network Meta-analysis of Randomized Control Trials (July 2022)-Management of Patellar Instability: A Network Meta-analysis of Randomized Control Trials (July 2022)

Management of Patellar Instability: A Network Meta-analysis of Randomized Control Trials (July 2022)

Pdf Summary

A network meta-analysis of randomized control trials was conducted to compare different surgical options for the management of patellar instability. The most common procedures include medial patellofemoral ligament (MPFL) reconstruction, MPFL repair, and nonoperative management. The study included 13 trials with a total of 789 patients, all with a minimum follow-up of 24 months. The results showed that MPFL reconstruction had the highest probability score (P score) and resulted in a significantly lower recurrence rate compared to MPFL repair and nonoperative management. MPFL repair also had a significantly lower recurrence rate compared to nonoperative management. Additionally, MPFL reconstruction resulted in significantly higher functional outcomes as measured by the Kujala score compared to nonoperative management, but not MPFL repair. Subgroup analysis revealed that MPFL reconstruction had the highest P score for all outcomes in patients with first-time dislocation. Overall, the study demonstrated that MPFL reconstruction is associated with the lowest rate of recurrent patellar instability and the best functional outcomes. However, there were limitations to the study, including the quality of the included studies and the underreporting of complication rates. Further research is needed to confirm these findings and to evaluate long-term outcomes and complications.

Keywords

network meta-analysis

randomized control trials

surgical options

patellar instability

medial patellofemoral ligament (MPFL) reconstruction

MPFL repair

nonoperative management

recurrence rate

functional outcomes

Kujala score