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This study was conducted in accordance with PRISMA and R\u2010AMSTAR guidelines. Data on redislocation rates, functional outcomes including the Kujala score for anterior knee pain, and complication rates were extracted. A meta\u2010analysis was used to pool the mean postoperative Kujala score and calculate the proportion of patients sustaining redislocations using a random effects model. Quality assessment of included studies was performed for all included studies using the MINORS and Detsky scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This review included a total of 25 studies and 1,361 patients. The pooled mean redislocation rate in 15 studies comprising 798 patients in the rehabilitation group was 30% (95% CI 25\u201336%, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200965%). Moreover, the pooled mean redislocation rate in 10 studies comprising 170 patients undergoing MPFL repair was 7% (95% CI 3\u201312%, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200930%). The pooled mean postoperative Kujala score in 8 studies comprising 396 patients in the rehabilitation group was 82.5 (95% CI 78.3\u201386.8, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200991%), compared to a score of 88 (95% CI 87\u201390, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200976%) in 3 studies comprising 94 patients in the repair group. Range of motion deficits was reported in 3.8% of 893 patients in the rehabilitation group and 2.0% of 205 patients in the repair group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MPFL repair resulted in a lower rate of redislocation, less knee pain, and noninferiority with respect to a range of motion deficits compared to nonoperative treatment for the management of acute first\u2010time patellar dislocations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07222-w","type":"journal-article","created":{"date-parts":[[2022,11,13]],"date-time":"2022-11-13T12:02:35Z","timestamp":1668340955000},"page":"2772-2783","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["MPFL repair after acute first\u2010time patellar dislocation results in lower redislocation rates and less knee pain compared to 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