Evidence map›Paper›PMID 41496495›Full record

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.

Shiv Patel, Omkar S Anaspure, Anthony N Baumann, Troy M Manz, R Justin Mistovich

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

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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0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Shiv PatelPerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0009-0009-2112-3652
Omkar S AnaspurePerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0001-9135-0484
Anthony N BaumannDepartment of Orthopaedic Surgery, Cleveland Clinic Akron General, Akron, Ohio, USA.ORCID 0000-0002-4175-3135
Troy M ManzCollege of Biological Sciences, University of Toledo, Toledo, Ohio, USA.
R Justin MistovichDepartment of Orthopedic Surgery, The MetroHealth System, Cleveland, Ohio, USA.ORCID 0000-0003-2098-7263

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Knee InjuriesLigaments, ArticularPatellofemoral JointHumansJoint InstabilityPatellar DislocationRandomized Controlled Trials as TopicRecurrencemedial patellofemoral ligamentMPFL reconstructionnonoperative treatmentpatellar dislocation

Identifiers

PMID41496495
PMCPMC12861543

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

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.