Isolated Medial Patellofemoral Ligament Reconstruction for the Treatment of Recurrent Lateral Patellar Dislocations: A Systematic Review and Meta-Analysis

INTRODUCTION: Being one of the most common acute knee disorders In children and adolescents, the incidence of patellar dislocations among pediatric patients is estimated to 43 per 100,000 with peak of age at 15 years.1 Briefly, a nonoperative treatment have been considered as the standard of care for patellar dislocations.5 However, recurrent patellar instability, osteochondral fractures with loose bodies, and failed non operative measures of functional rehabilitation benefitted from surgical treatment.6 As for the purpose of return-to-sports after surgery, clinicians have been using the utilization of time, ROM, strength, and subjective measures as guidelines.2,10 METHODS: The population size was harvested from each study as well as means/medians and ranges for population age and follow-up time. Recurrent instability were taken to note, preoperative and postoperative Tegner for estimated return to play, positive apprehension test and Kujala scores were extracted. he study calculate means for population size, age, postoperative Tegner scores. RESULTS: The total mean population size of all 6 studies was 217 participants, with a mean age and follow-up of 23.5 years and 30.8 months, respectively. The data extracted from all studies included in the review, as well as all calculated means, are presented in Table 3. The total mean population size of all 6 studies was 217 participants, with a mean age and follow-up of 23.5 years and 30.8 months, respectively. CONCLUSION: The mean postoperative Tegner score was 5.7, calculated from 4 studies. Preinjury and preoperative Tegner scores were reported in only one study. The pooled proportion of athletes who returned to sports after surgery was 84.1% (95% CI, 71.1%– 97.1%) (Figure 1). The pooled estimated mean from 7 studies that reported means ± SDs for the postoperative Kujala score was 85.8 (95% CI, 81.6–90.0; I2 = 92%) (Figure 2). Also, 4 studies reported the frequency at which patients exhibited a positive apprehension sign during follow-up; the pooled risk from these studies was 3.6% (95% CI, 0%–7.2%) (Figure 3). The pooled total risk of recurrent instability after surgery was 1.2% (95% CI, 0.3%–2.1%; I2 = 0%)