Operative Versus Nonoperative Treatment of Medial Patellofemoral Ligament Injuries: A Systematic Review and Meta-analysis of Randomized Controlled Trials With Trial Sequential Analysis

Operative treatment of MPFL injuries resulted in a robust and significantly lower rate of recurrent instability when compared with nonoperative treatment, although there was no difference in Kujala scores. Given the current evidence, operative treatment appears to be the more ideal approach to treating first-time patellar dislocations. However, the key to these findings is the need for further studies, as TSA showed that the current level of evidence is insufficient to draw definitive conclusions.