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Evidence summaries

Surgical Vs. Non-Surgical Interventions for Patellar Dislocation

In acute primary dislocation of the patella, initial surgery may not provide any benefit compared to conservative treatment. Level of evidence: "C"

Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment, lack of blinding) and byimprecise results (few patients).

Summary

A Cochrane review [Abstract] 1 on surgical vs. non-surgical interventions for treating patellar dislocation included 5 studies with a total of 339 subjects. Follow-up was a minimum of 2 years in 2 studies and between 5 and 7 years in 3 studies. There was no significant difference between surgical and non-surgical management of primary (first-time) patellar dislocation in the risk of recurrent dislocation (47/182 versus 53/157; RR 0.81, 95% CI 0.56 to 1.17; 5 trials), Kujala patellofemoral disorder scores (MD 3.13, 95% CI -7.34 to 13.59; 5 trials) nor the requirement for subsequent surgery (RR 1.09, 95% CI 0.72 to 1.65; 3 trials). Adverse events were reported by one trial, citing four major complications that occurred in the surgical group. No randomised controlled trials have assessed populations with recurrent patellar dislocation.

Clinical comments

Note

Date of latest search:

    References

    • Hing CB, Smith TO, Donell S et al. Surgical versus non-surgical interventions for treating patellar dislocation. Cochrane Database Syst Rev 2011;(11):CD008106. [PubMed]

Primary/Secondary Keywords