title: Comparison operative and conservative management for primary patellar dislocation: an up-to-date meta-analysis.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Orthopaedics, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin, 300052, People's Republic of China, yaoliwei2011@126.com.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Yao
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.forename: Dai-Gui
authors.initials: DG
authors.lastname: Cao
authors.forename: De-Jin
authors.initials: DJ
authors.lastname: Li
authors.forename: Dong-Dong
authors.initials: DD
authors.lastname: Xu
authors.forename: Shi-Qing
authors.initials: SQ
authors.lastname: Feng
mesh_terms: D000328:Adult; D001915:Braces; D002370:Casts, Surgical; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007103:Immobilization / Q000379:methods; D008297:Male; D031222:Patellar Dislocation / Q000628:therapy*; D017060:Patient Satisfaction; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D055815:Young Adult