Editorial Commentary: Proximal Stabilization for Recurrent Patellar Dislocation--Respect the Anatomy and Achieve Excellent Outcomes Regardless of Specific Technique.

Abstract

In a Level IV evidence systematic review of 13 studies comparing medial patellofemoral ligament reconstruction and medial soft-tissue realignment for recurrent lateral patellar instability without osseous pathology, both techniques showed excellent outcomes with low recurrent dislocation rates (<10% for both) without significant clinical, radiographic, or instability differences between the two groups at minimum 2-year follow-up. As in all well-designed and -conducted systematic reviews, the authors delicately balance study homogeneity (similar patients and surgical procedures-excluding distal osseous realignment and first-time dislocators) and heterogeneity (improved generalizability: dichotomized medial soft-tissue realignment and medial patellofemoral ligament reconstruction).