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- Title
Comparison operative and conservative management for primary patellar dislocation: an up-to-date meta-analysis.
- Authors
Yao, Li-Wei; Zhang, Chao; Liu, Yang; Cao, Dai-Gui; Li, De-Jin; Xu, Dong-Dong; Feng, Shi-Qing
- Abstract
Purpose: The aim of this review was to compare the clinical outcomes between operative and conservative management for primary patella dislocation (PPD). Methods: PubMed Medline, EMBASE, Google scholar, and the Cochrane Library were systematically searched for randomized controlled trials that compared operative technique versus conservative technique for PPD. The results of eligible studies were independently extracted and analyzed according to the following: patient's satisfaction, Kujala score, Tegner score, and redislocation rate. Random-effect and fixed-effect models were adopted to calculate the weight mean difference and the odds ratio for continuous and dichotomous variables with 95 % confidence interval. Results: Seven studies met the inclusion criteria, resulting in 402 (216 surgery and 186 conservation) patients available for the present study. A meta-analysis showed no significant differences between the two treatment groups in terms of patient's satisfaction and Kujala score. However, significant differences in Tegner score ( P < 0.00001) and redislocation rate ( P = 0.002) were observed in favor of surgical treatment. In the subgroup analysis, surgical intervention achieved higher ( P = 0.002) Kujala score in short term (<5 years), while conservation gained advantage ( P = 0.003) in long term (>5 years). There was no significant difference in dislocation rate in long term. Conclusions: Surgical treatment might provide better clinical results in short term. More persuasive evidence is still needed to proof the effect of surgical management in long time.
- Subjects
KNEE injury treatment; CHI-squared test; CONFIDENCE intervals; INFORMATION storage &; retrieval systems; MEDICAL databases; MEDICAL information storage &; retrieval systems; MEDLINE; META-analysis; ONLINE information services; PATIENT satisfaction; PHYSICAL therapy; SYSTEMATIC reviews; ODDS ratio
- Publication
European Journal of Orthopaedic Surgery & Traumatology, 2015, Vol 25, Issue 4, p783
- ISSN
1633-8065
- Publication type
Article
- DOI
10.1007/s00590-014-1523-z