Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (44): 8228-8234.doi: 10.3969/j.issn.2095-4344.2012.44.012

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Meta analysis on the treatment of acute patellar dislocation by surgical versus conservative treatment

Tian Wen, Wang Fu-ming, Huang Jian, Chen Lu-yao, Hu Shi-qiang, Peng Ai-ping   

  1. First Department of Orthopedics, Xiaolan People’s Hospital of Southern Medical University, Zhongshan 528415, Guangdong Province, China
  • Received:2012-08-04 Revised:2012-09-28 Online:2012-10-28 Published:2012-10-28
  • About author:Tian Wen, Associate chief physician, First Department of Orthopedics, Xiaolan People’s Hospital of Southern Medical University, Zhongshan 528415, Guangdong Province, China tianwenpen@126.com

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Abstract:

BACKGROUND: Acute patellar dislocation is more common in clinic, but there is controversial about surgical treatment and conservative treatment.
OBJECTIVE: To compare the clinical therapeutic effects of surgical versus conservative treatment method for acute patellar dislocation and to guide the selection of clinical treatment options.
METHODS: The Coehrane Library (Issue 4, 2012), MEDLINE (from 1966 to April 2012), EMBase (from 1966 to April 2012), CBM database (from January 1979 to April 2012), PubMed database (from June 1966 to 2012) and Wangfang database (from beginning to April 2012) were searched with computer and the Chinese orthopedic journals were searched by hand for the randomized controlled trials and clinical trials on comparison of surgical versus conservative treatment method for acute patellar dislocation. Meta analysis was conducted using the Cachrane Collaboration’s RevMan 5.1 software. The risk of recurrent dislocation, Kujala scores after operation, the excellent and good rate based on Kujala scores and re-operation rate during follow-up were observed after treated with surgical and conservative treatment methods.
RESULTS AND CONCLUSION: Only six randomized controlled trials were included involving 380 patients (203 patients in surgical group and 117 patients in conservative group) met the criteria of the present study. Meta analysis results showed that there was no significant difference between surgical and conservative group of acute patellar dislocation in the risk of recurrent dislocation [relative risk (RR)=0.54, 95% confidence interval (CI): 0.28-1.07], Kujala scores [weighted mean difference (WMD)=5.50, 95%CI: -4.46-15.45], excellent and good rate based on Kujala scores (RR=2.53, 95%CI: 0.47-13.56) and re-operation rate during follow-up (RR=1.09, 95%CI: 0.72-1.65) (P > 0.05). Further analysis was performed between the short-term 2-5 years follow-up group and long-term 5-7 years follow-up group, and found that only in the short-term 2-5 years follow-up group, the Kujala scores of surgical group were better than that of the conservative group (WMD=15.52, 95%CI: 5.67-25.38, P < 0.05). For patients with acute patellar dislocation, the surgical treatment result is equivalent to conservative treatment, but the short-term recovery knee function after surgical treatment is superior to conservative treatment.

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