title: Outcomes After Isolated Medial Patellofemoral Ligament Reconstruction for the Treatment of Recurrent Lateral Patellar Dislocations: A Systematic Review and Meta-analysis.
abstract: A patellar dislocation is a common knee injury in the young, athletic patient population. Recent trends indicate that the use of long-term nonoperative treatment is decreasing, and surgical intervention is more commonly recommended for those patients who fail initial nonoperative management with recurrent patellar dislocations. Medial patellofemoral ligament (MPFL) reconstruction has become increasingly utilized in this regard.
  
  
  
  To evaluate outcomes, particularly return to sports and its relationship to postoperative instability, of isolated MPFL reconstruction for the treatment of recurrent patellar dislocations.
  
  
  
  Systematic review and meta-analysis.
  
  
  
  A review of the current literature was performed using the terms "medial patellofemoral ligament reconstruction" and "MPFL reconstruction" in the electronic search engines PubMed and EBSCOhost (CINAHL, MEDLINE, SPORTDiscus) on July 29, 2015, yielding 1113 abstracts for review. At the conclusion of the search, 14 articles met the inclusion criteria and were included in this review of the literature. Means were calculated for population size, age, follow-up time, and postoperative Tegner scores. Pooled estimates were calculated for postoperative Kujala scores, return to play, total risk of postoperative instability, risk of positive apprehension sign, and risk of reoperation.
  
  
  
  The mean patient age associated with MPFL reconstruction was 24.4 years, with a mean postoperative Tegner score of 5.7. The pooled estimated mean postoperative Kujala score was 85.8 (95% CI, 81.6-90.0), with 84.1% (95% CI, 71.1%-97.1%) of patients returning to sports after surgery. The pooled total risk of recurrent instability after surgery was 1.2% (95% CI, 0.3%-2.1%), with a positive apprehension sign risk of 3.6% (95% CI, 0%-7.2%) and a reoperation risk of 3.1% (95% CI, 1.1%-5.0%).
  
  
  
  A high percentage of young patients return to sports after isolated MPFL reconstruction for chronic patellar instability, with short-term results demonstrating a low incidence of recurrent instability, postoperative apprehension, and reoperations.
authors.affiliation: Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.|College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Schneider
authors.affiliation: Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, USA.|Division of Sports Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Grawe
authors.affiliation: Department of Orthopaedics, Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Magnussen
authors.affiliation: Visiting Nurse Association, Cincinnati, Ohio, USA.|United Way of Greater Cincinnati, Cincinnati, Ohio, USA.
authors.forename: Adrick
authors.initials: A
authors.lastname: Ceasar
authors.affiliation: Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Shital N
authors.initials: SN
authors.lastname: Parikh
authors.affiliation: Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Wall
authors.affiliation: Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, USA.|Division of Sports Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
authors.forename: Angelo J
authors.initials: AJ
authors.lastname: Colosimo
authors.affiliation: Department of Orthopaedics, Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Kaeding
authors.affiliation: Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA greg.myer@cchmc.org.|Department of Orthopaedic Surgery, University of Cincinnati, Cincinnati, Ohio, USA.|Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA.|The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA.|Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Myer
mesh_terms: D006801:Humans; D015994:Incidence; D007593:Joint Instability / Q000453:epidemiology* / Q000209:etiology; D031222:Patellar Dislocation / Q000209:etiology / Q000601:surgery*; D017847:Patellar Ligament / Q000601:surgery*; D011184:Postoperative Period; D012008:Recurrence; D000068958:Return to Sport / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: MPFL reconstruction; medial patellofemoral ligament; patellar instability; patellar reconstruction