title: Is surgical treatment better than conservative treatment for primary patellar dislocations? A meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Despite several randomized controlled trials comparing operative to nonoperative management of primary patellar dislocation, the optimal management of this condition remains a subject of controversy. The aim of this study was to compare surgical to conservative treatment of outcomes for primary patellar dislocation by meta-analysis all the relative randomized controlled trials.
  
  
  METHODS
  Meta-analysis.
  
  
  METHODS
  After searching multiple online databases (MEDILINE, EMBASE, CLINICAL, OVID, BISOS and Cochrane registry of controlled clinical trials), eight randomized controlled trials including 430 patients were meta-analyzed in which operative treatment was compared with non-operative treatment for primary patellar dislocation. Outcomes evaluated were redislocation rate, Kujala score, episode of instability, Tegner activity score, Hughston visual analog score (VAS) and patient satisfaction.
  
  
  RESULTS
  Outcomes on recurrent patellar dislocation (P = 0.004) and Hughston VAS (P = 0.03) were statistically significant in favor of operative management. Tegner activity score (P < 0.00001) was significantly higher in favor of conservative treatment, though only a few studies were identified. There was no significant difference between the two treatments regarding episode of instability (P = 0.41), Kujala score (P = 0.32) or patient satisfaction (P = 0.49).
  
  
  CONCLUSIONS
  Surgical treatment may be better than conservative treatment for patients with primary patellar dislocation on incidence of redislocation. However, since these findings are built on a limited number of studies available, well-designed, multicenter clinical trials with long-term follow-up are required to provide more solid evidence concerning optimal strategies.
authors.affiliation: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Ave. North, Baiyun District, Guangzhou, 510515, People's Republic of China. 151102352@qq.com.
authors.forename: Sheng-nan
authors.initials: SN
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Ave. North, Baiyun District, Guangzhou, 510515, People's Republic of China. doctorqin@163.com.
authors.forename: Cheng-he
authors.initials: CH
authors.lastname: Qin
authors.affiliation: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Ave. North, Baiyun District, Guangzhou, 510515, People's Republic of China. hnxyjn@smu.edu.cn.
authors.forename: Nan
authors.initials: N
authors.lastname: Jiang
authors.affiliation: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Ave. North, Baiyun District, Guangzhou, 510515, People's Republic of China. 81297810@qq.com.
authors.forename: Bo-wei
authors.initials: BW
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Ave. North, Baiyun District, Guangzhou, 510515, People's Republic of China. 35314031@qq.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Ave. North, Baiyun District, Guangzhou, 510515, People's Republic of China. yubinortho@126.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Yu
mesh_terms: D016208:Databases, Factual; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology; D019637:Orthopedic Procedures / Q000379:methods*; D010146:Pain; D031222:Patellar Dislocation / Q000628:therapy*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012107:Research Design
keywords: Conservative management; Meta-analysis; Outcomes; Primary patellar dislocation; Surgery; Treatment