Medial Soft-Tissue Realignment Versus Medial Patellofemoral Ligament Reconstruction for Recurrent XXXX : Systematic Review.

@entity1 @entity8043
PURPOSE: To compare the clinical outcomes between medial soft-tissue surgery and medial patellofemoral ligament (MPFL) reconstruction for recurrent @entity8043 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 @entity8043 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 @entity1 undergoing medial soft-tissue surgery, compared with 7 studies reporting MPFL reconstruction. Overall, 109 @entity1 underwent medial soft-tissue surgery with a minimum 2-years follow-up, compared with 308 @entity1 of MPFL reconstruction. There was one direct comparative study between medial soft-tissue surgery and MPFL reconstruction. Of the @entity1 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 @entity1 who underwent medial soft-tissue surgery and 23.11 to 38.8 points in @entity1 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 @entity8043 without predisposing factors showed satisfactory outcomes despite the use of numerous surgical techniques, graft types, and follow-up periods. LEVEL OF EVIDENCE: Level IV, Systematic Review.
