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Quality of selected papers was assessed using the Methodological Index for Non\u2010Randomised Studies (MINORS) and the Risk of Bias (RoB) 2.0 protocol. Results were qualitatively synthesised, and descriptive statistics were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty studies totalling 3074 patients (1407 females) were included for the analysis. The mean age was 18.9 years (range 0\u201369). The population included 2446 first\u2010time dislocations. The imaging modalities used were: 71.1% MRI, 52.6% plain radiography, 12.1% CT, and 0.68% ultrasound. In the 25 studies that reported the number of OCF, a total of 38.3% of patients were found to have OCF. 43.3% of patients with a first\u2010time dislocation, and 34.7% of patients with previous dislocations, had at least one OCF. In the included paediatric studies (maximum age\u2009\u2264\u200918), the presence of OCF was detected by plain radiography in 10.1% of patients, MRI in 76.6% of patients, and CT in 89.5% of patients. For management of an OCF, the surgical options include fixation for larger pieces, excision for smaller pieces, and conservative management on a case\u2010by\u2010case basis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on the current available evidence, assessment and management of patellar dislocations and subsequent OCFs vary, with radiography and MRI as the main imaging modalities on presentation and particular benefit for MRI in the paediatric population. Findings from this study suggest the highest rate of OCF detection with MRI, and thus, surgeons should consider routinely ordering an MRI in patients with first\u2010time patellar dislocation. Regarding management of OCFs, the main indication for fixation was large fragments, while smaller and poor\u2010quality fragments are excised. Few studies choose conservative management of OCFs due to later requirements for surgical management. Future work should focus on large, high\u2010quality studies, and implementation of randomised control trials to form guidelines for imaging patellar dislocations and management of OCFs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07043-x","type":"journal-article","created":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T09:04:00Z","timestamp":1657184640000},"page":"1744-1752","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["MRI as the optimal imaging modality for assessment and management of osteochondral fractures and loose bodies following traumatic patellar dislocation: a systematic review"],"prefix":"10.1002","volume":"31","author":[{"given":"Reva Y.","family":"Qiu","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Michael G. 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DeGroote School of Medicine McMaster University 1280 Main Street West L8S 4L8 Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Cohen","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Division of Orthopaedic Surgery, Department of Surgery McMaster University 1280 Main Street West, MUMC 4E14 L8S 4L8 Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Kay","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Division of Orthopaedic Surgery, Department of Surgery McMaster University 1280 Main Street West, MUMC 4E14 L8S 4L8 Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Almasri","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Mercy Health\u2014Orthopedics and Sports Medicine 4701 Creek Rd Suite 110 45242 Blue Ash OH 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