Operative versus conservative treatment for patellar dislocation: a meta-analysis of 7 randomized controlled trials

Purpose: Patellofemoral pathology is common, and patellofemoral dislocation mainly affects adolescents and young adults. We conducted a meta-analysis exclusively of RCTs to compare the clinical outcomes of patellar dislocation patients managed operatively versus non-operatively. Methods: After systematic review of electronic databases and websites, a total of 7 RCTs reporting data on 402 subjects were included. The methodological quality of the literature was assessed using the PEDro critical appraisal tool. Mean differences (MDs) and risk ratio (RR) were calculated for the pooled effects. Heterogeneity was assessed using the I-2 test. Results: Data synthesis showed a lower rate of recurrent patellar dislocation post-treatment in patients managed operatively compared to non-operatively (P = 0.01). Conclusion: The results suggest a difference in outcomes between the treatment strategies. However the limited number of studies and high risk of inherent bias indicate that future studies involving more patients in better-designed randomized controlled trials will be required.