SynthesisThe American journal of sports medicine2026
Operative Versus Nonoperative Treatment of Medial Patellofemoral Ligament Injuries: A Systematic Review and Meta-analysis of Randomized Controlled Trials With Trial Sequential Analysis.
Synthesis in The American journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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Abstract
backgroundThe medial patellofemoral ligament (MPFL) serves as a major stabilizer in the knee, providing restraint against lateral patellar translation. The optimal approach for treating patients with first-time MPFL injuries remains uncertain, as the choice between operative and nonoperative treatment depends on the risks and variability associated with individual patient anatomy, activity, and presentation. PURPOSE: To evaluate high-level literature on outcomes after operative and nonoperative treatment of MPFL injuries to guide decision-making. STUDY
designMeta-analysis; Level of evidence, 1.
methodsThis systematic review and meta-analysis utilized PubMed, CINAHL, MEDLINE, Web of Science, and SPORTDiscus through November 25, 2024, to find randomized controlled trials that assess the outcomes associated with operative versus nonoperative treatment for MPFL tears. The primary outcomes were rates of recurrent dislocation and patient-reported outcomes. Statistical analysis included relative risk (RR) with 95% confidence intervals (95% CIs) along with trial sequential analysis (TSA) and assessment of fragility index.
resultsA total of 306 patients (55.9% female) had a frequency-weighted mean ± SD age of 19.68 ± 4.24 years (range, 9-40) and follow-up time of 21.61 ± 5.34 months and underwent nonoperative (n = 147) or operative (n = 159) treatment. When compared with nonoperative treatment, operative treatment had a significantly lower rate of recurrent instability (10.69% vs 29.93%; RR, 2.49; 95% CI, 1.34-4.61;
conclusionOperative treatment of MPFL injuries resulted in a robust and significantly lower rate of recurrent instability when compared with nonoperative treatment, although there was no difference in Kujala scores. Given the current evidence, operative treatment appears to be the more ideal approach to treating first-time patellar dislocations. However, the key to these findings is the need for further studies, as TSA showed that the current level of evidence is insufficient to draw definitive conclusions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.