Operative Repair of Medial Patellofemoral Ligament Injury Versus Knee Bracing in Acute First-Time Traumatic Patellar Dislocation: A Systematic Review and Meta-Analysis

Abstract

Acute first-time traumatic patellar dislocation is a prevalent knee injury, particularly in adolescents, often managed conservatively with knee bracing. Recently, medial patellofemoral ligament (MPFL) reconstruction has gained popularity for its potential benefits in reducing redislocation rates and enhancing functional outcomes. This systematic review and meta-analysis compared the outcomes of MPFL reconstruction versus knee bracing for managing acute first-time traumatic patellar dislocation. A comprehensive search of PubMed, Scopus, Google Scholar, and the Cochrane Library identified studies published within the last 10 years that directly compared these treatment approaches, with primary outcomes focusing on redislocation rates and functional recovery measured by Kujala scores. A total of six studies, involving 325 patients, were included in the analysis. Results indicated that MPFL reconstruction significantly reduced redislocation rates (OR: 0.17, 95% CI: 0.09 to 0.32, P < 0.00001) and improved functional outcomes (MD in Kujala scores: 8.10, 95% CI: 6.46 to 9.75) compared to knee bracing. Despite notable heterogeneity across studies (I² = 95%), MPFL reconstruction consistently demonstrated superior long-term knee stability and fewer reoperations. These findings suggest that surgical intervention is the preferred treatment for long-term stability; however, further high-quality randomized controlled trials are recommended to confirm these results.