Paper # 110: Prospective Randomized Study About the Traumatic Patellar Dislocation: The Conservative Treatment and the MPFL Reconstruction with Patellar Tendon – A Minimum 2-Year Follow-Up

Bitar, Alexandre Carneiro; Camanho, Gilberto Luís; D’Elia, Caio Oliveira; Demange, Marco Kawamura; Viegas, Alexandre de Christo

doi:10.1016/j.arthro.2011.08.110

Cited by 2 publications

(6 citation statements)

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“… 2 , 39 , 45 , 49 Significant methodological weaknesses existed in the literature; information specifying the randomization protocol was lacking (eg, failing to specify who performed the random allocation sequence and enrolled/assigned participants) in up to 9 studies, ¶ 4 studies provided insufficient information regarding the interventions to permit replication, 2 , 7 , 35 , 46 4 did not specify the location of the population recruited, 7 , 24 , 38 , 46 3 studies provided no evidence for how the sample size was estimated (ie, showed no power calculations), 24 , 34 , 35 and 1 did not outline the follow-up period. 7 Only 3 studies satisfactorily reported CIs, making an assessment of the effect size difficult. 24 , 34 , 49 …”

Section: Resultsmentioning

confidence: 99%

“…Because of the limited number of studies implementing proprioceptive exercises, closed/open chain exercises, and electrostimulation, 1 , 2 , 7 , 48 , 58 these studies were assessed alone. Studies using proprioceptive exercises reported Lysholm scores of between 70 and 89.3 at follow-up.…”

Section: Resultsmentioning

confidence: 99%

“… 2 , 7 , 58 Bitar et al 7 evolved closed chain to open chain exercises, while Sillanpaa et al 48 used both concurrently; redislocation rates were 35% and 54.8%, respectively, 7 , 48 compared with the pooled redislocation rate of 31% from all studies. The 2 studies implementing electrostimulation used different PROMs: Bitar et al 7 used the Kujala score, and Armstrong et al 2 used the Lysholm score. Furthermore, redislocation rates could only be gathered from Bitar et al, 7 making qualitative comparisons difficult.…”

Section: Resultsmentioning

confidence: 99%

“…The 2 studies implementing electrostimulation used different PROMs: Bitar et al 7 used the Kujala score, and Armstrong et al 2 used the Lysholm score. Furthermore, redislocation rates could only be gathered from Bitar et al, 7 making qualitative comparisons difficult.…”

Section: Resultsmentioning

confidence: 99%

“…Various physical therapy techniques have been described with the aims of strengthening the quadriceps muscles; restoring range of movement; addressing deficiencies in hip, trunk, or foot biomechanics that may precipitate instability; reducing pain; and improving patient confidence. 7 , 10 , 48 Different methods of immobilization have also been used in the acute phase, and this also remains controversial. There are little data to determine which regimen is best or even what approaches are most commonly used in practice.…”

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confidence: 99%

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Clinical Outcomes After the Nonoperative Management of Lateral Patellar Dislocations: A Systematic Review

Moiz

Smith

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:The first-line treatment for patellar dislocations is often nonoperative and consists of physical therapy and immobilization techniques, with various adjuncts employed. However, the outcomes of nonoperative therapy are poorly described, and there is a lack of quality evidence to define the optimal intervention.Purpose:To perform a comprehensive review of the literature and assess the quality of studies presenting patient outcomes from nonoperative interventions for patellar dislocations.Study Design:Systematic review; Level of evidence, 4.Methods:The MEDLINE, AMED, Embase, CINAHL, Cochrane Library, PEDro, and SPORTDiscus electronic databases were searched through July 2017 by 3 independent reviewers. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Study quality was assessed using the CONSORT (Consolidated Standards for Reporting Trials) criteria for randomized controlled trials and the Newcastle-Ottawa Scale for cohort studies and case series.Results:A total of 25 studies met our inclusion criteria, including 12 randomized controlled trials, 7 cohort studies, and 6 case series, consisting of 1066 patients. Studies were grouped according to 4 broad categories of nonoperative interventions based on immobilization, weightbearing status, quadriceps exercise type, and alternative therapies. The most commonly used outcome measure was the Kujala score, and the pooled redislocation rate was 31%.Conclusion:This systematic review found that patient-reported outcomes consistently improved after all methods of treatment but did not return to normal. Redislocation rates were high and close to the redislocation rates reported in natural history studies. There is a lack of quality evidence to advocate the use of any particular nonoperative technique for the treatment of patellar dislocations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Clinical Outcomes After the Nonoperative Management of Lateral Patellar Dislocations: A Systematic Review

Moiz

Smith

et al. 2018

Orthopaedic Journal of Sports Medicine

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Reimagined MPFL Reconstruction: Retinacular Fixation of the Doubled Hamstring Graft at the Patella and Suture Anchor-Based Femoral Fixation

Nazeer,

Goel,

Nazeer

et al. 2023

Advances in Orthopedics

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Background. Lateral patellar dislocation is frequently observed among teenagers and young adults. There is no consensus on the best type of graft or fixation strategy for the femur and patella, and complications such as iatrogenic patella fracture, tunnel malposition, and grafting failure are common. The objective of our research is to find out the functional outcome of a new method of medial patellofemoral ligament (MPFL) reconstruction, which involves two key components: (1) patellar fixation is accomplished by suturing the two limbs of the looped doubled hamstring graft in a divergent fashion to the retinaculum at the medial border of the upper half of patella and (2) the placement of a suture anchor tied to the graft at the isometric point on the medial femur condyle. Methods. This study is a retrospective assessment of patients who underwent MPFL reconstruction at our hospital between September 2018 and August 2020. Patients were monitored for at least 2 years after the initial procedure until August 2022. Results. A total of 29 patients were recruited for the study, with 22 being females and the average age being 30.38 years. During the postoperative period, none of the participants experienced instability, redislocation, patellar/femoral fractures, or abnormal distal femur growth. The Tegner–Lysholm knee score was good to excellent for 17 (58.6%) participants, fair for 10 (34.5%) participants, and poor for 2 (6.9%) participants. The Kujala anterior knee pain score was more than 80 for 19 (65.5%) participants. Conclusion. This research presents a significant achievement rate of the surgical procedure, accompanied by the mean Tegner–Lysholm knee score of 82.68 and the mean Kujala anterior knee pain score of 82.71. Notably, there were no complications observed in the postoperative period.

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Paper # 110: Prospective Randomized Study About the Traumatic Patellar Dislocation: The Conservative Treatment and the MPFL Reconstruction with Patellar Tendon – A Minimum 2-Year Follow-Up

Cited by 2 publications

References 0 publications

Clinical Outcomes After the Nonoperative Management of Lateral Patellar Dislocations: A Systematic Review

Clinical Outcomes After the Nonoperative Management of Lateral Patellar Dislocations: A Systematic Review

Reimagined MPFL Reconstruction: Retinacular Fixation of the Doubled Hamstring Graft at the Patella and Suture Anchor-Based Femoral Fixation

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