title: Medial Soft-Tissue Realignment Versus Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Dislocation: Systematic Review.
abstract: OBJECTIVE
  To compare the clinical outcomes between medial soft-tissue surgery and medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar dislocation without any evident predisposing factors.
  
  
  METHODS
  A literature search was performed on the established medical databases MEDLINE, EMBASE, and the Cochrane register. The inclusion criteria were as follows: English-language papers for recurrent patellar dislocation without any evident predisposing factors, clinical trial(s) with clear description of surgical technique, adult subjects, medial soft-tissue surgery or MPFL reconstruction without combined surgery, and a follow-up longer than 2 years. The methodological quality of all articles was assessed by 2 authors according to the Coleman methodology score.
  
  
  RESULTS
  Thirteen studies (mean Coleman methodology score value, 74.1; standard deviation, 11.5) were included in the analysis. Five studies reported the outcomes of patients undergoing medial soft-tissue surgery, compared with 7 studies reporting MPFL reconstruction. Overall, 109 patients underwent medial soft-tissue surgery with a minimum 2-years follow-up, compared with 308 patients of MPFL reconstruction. There was one direct comparative study between medial soft-tissue surgery and MPFL reconstruction. Of the patients who received medial soft-tissue surgery, 0 to 9.7% experienced redislocation, compared with 0 to 10.7% of the MPFL reconstruction group. The ranges of differences in Kujala scores were 23.6 to 31.7 points in patients who underwent medial soft-tissue surgery and 23.11 to 38.8 points in patients who underwent MPFL reconstruction. The ranges of postoperative congruence angles were -14.4° to 8.2° for medial soft-tissue surgery and -7.7° to -5.2° for MPFL reconstruction. The ranges of postoperative lateral patellofemoral angles were 7.9° to 9.4° for medial soft-tissue surgery and 5° to 5.3° for MPFL reconstruction.
  
  
  CONCLUSIONS
  All studies on medial soft-tissue surgery and MPFL reconstruction for recurrent patellar dislocation without predisposing factors showed satisfactory outcomes despite the use of numerous surgical techniques, graft types, and follow-up periods.
  
  
  METHODS
  Level IV, Systematic Review.
authors.affiliation: Department of Orthopedic Surgery, Aerospace Medical Center, Republic of Korea Air Force, Cheongju-si, Republic of Korea.
authors.forename: Jae-Gwang
authors.initials: JG
authors.lastname: Song
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Boramae Hospital, Seoul, Republic of Korea.
authors.forename: Seung-Baik
authors.initials: SB
authors.lastname: Kang
authors.affiliation: Department of Biostatistics, Seoul National University Boramae Hospital, Seoul, Republic of Korea.
authors.forename: So-Hee
authors.initials: SH
authors.lastname: Oh
authors.affiliation: Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Ilsan, Republic of Korea.
authors.forename: Jae-Hwi
authors.initials: JH
authors.lastname: Han
authors.affiliation: Department of Orthopaedic Surgery, B. J. Medical College and New Civil Hospital, Ahmedabad, India.
authors.forename: Daivesh
authors.initials: D
authors.lastname: Shah
authors.affiliation: Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Ilsan, Republic of Korea.
authors.forename: Hyung-Joon
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, Tashkent Medical Academy, Tashkent, Uzbekistan.
authors.forename: Umid T
authors.initials: UT
authors.lastname: Kholmurodov
authors.affiliation: Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Ilsan, Republic of Korea. Electronic address: kwnhamj@hotmail.com.
authors.forename: Kyung-Wook
authors.initials: KW
authors.lastname: Nha
mesh_terms: D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D031222:Patellar Dislocation / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence