{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T10:00:28Z","timestamp":1773568828460,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,1,28]],"date-time":"2015-01-28T00:00:00Z","timestamp":1422403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,1,28]],"date-time":"2015-01-28T00:00:00Z","timestamp":1422403200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2015,1,28]],"date-time":"2015-01-28T00:00:00Z","timestamp":1422403200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","arthroscopyjournal.org","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To conduct a systematic review of meta\u2010analyses comparing nonoperative and operative treatment of patellar dislocations to elucidate the cause of the variation and to determine which meta\u2010analysis provides the current best available evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review of the literature to identify meta\u2010analyses was performed. Data were extracted for patient outcomes and recurrent dislocations. Meta\u2010analysis quality was assessed using the Oxman\u2010Guyatt and Quality of Reporting of Meta\u2010analyses systems. The Jadad algorithm was then applied to determine which meta\u2010analysis provided the highest level of evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four meta\u2010analyses met the eligibility criteria: 1 Level I evidence, 2 Level II evidence, and 1 Level III evidence. A total of 1,984 patients were included (997 underwent surgery whereas 987 underwent conservative treatment). Three meta\u2010analyses found a lower subsequent patellar dislocation rate in patients managed operatively compared with nonoperatively, whereas one did not find a difference in recurrent dislocation rates between the operative and nonoperative groups. When the results of all the studies were combined, the overall redislocation rate was 29.4% and the rate of recurrent instability episodes was 32.8%. Patients treated operatively had a 24.0% rate of repeat patellar dislocation and a 32.7% rate of recurrent patellar instability, whereas patients treated nonoperatively had a 34.6% rate of repeat patellar dislocation and a 33.0% rate of recurrent instability. In addition, 1 meta\u2010analysis found a significantly higher rate of patellofemoral osteoarthritis in the operative group. No differences in functional outcomes scores were seen between treatments. Two meta\u2010analyses had low Oxman\u2010Guyatt scores (&lt;4), indicative of major flaws.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>According to the best available evidence, operative treatment of acute patellar dislocations may result in a lower rate of recurrent dislocations than nonoperative treatment but does not improve functional outcome scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, systematic review of Level I, II, and II studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2014.11.040","type":"journal-article","created":{"date-parts":[[2015,1,28]],"date-time":"2015-01-28T01:42:44Z","timestamp":1422409364000},"page":"1207-1215","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":78,"title":["Does Operative Treatment of First\u2010Time Patellar Dislocations Lead to Increased Patellofemoral Stability? A Systematic Review of Overlapping Meta\u2010analyses"],"prefix":"10.1002","volume":"31","author":[{"given":"Brandon J.","family":"Erickson","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randy","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eli T.","family":"Sayegh","sequence":"additional","affiliation":[{"name":"College of Physicians and Surgeons Columbia University New York New York U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan","family":"Saltzman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil N.","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles A.","family":"Bush\u2010Joseph","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian J.","family":"Cole","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Bernard R.","family":"Bach","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,1,28]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/BLO.0b013e31802eb40a"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B1.14924"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.jsm.0000157315.10756.14"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/17453670510041790"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511423742"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e318299cb50"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2751-1"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)04149-5"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(91)90160-B"},{"key":"e_1_2_2_11_2","first-page":"1411","article-title":"A\u00a0guide to interpreting discordant systematic reviews","volume":"156","author":"Jadad A.R.","year":"1997","journal-title":"CMAJ"},{"issue":"11","key":"e_1_2_2_12_2","first-page":"CD008106","article-title":"Surgical versus non\u2010surgical interventions for treating patellar dislocation","author":"Hing C.B.","year":"2011","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_2_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-013-1400-1"},{"key":"e_1_2_2_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1746-1596-9-60"},{"key":"e_1_2_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-010-1355-2"},{"key":"e_1_2_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-011-1265-z"},{"key":"e_1_2_2_17_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.74B1.1732244"},{"key":"e_1_2_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2008.12.005"},{"key":"e_1_2_2_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354658801600308"},{"key":"e_1_2_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2008.03.012"},{"key":"e_1_2_2_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01565476"},{"key":"e_1_2_2_22_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453679708996254"},{"key":"e_1_2_2_23_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00072"},{"key":"e_1_2_2_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-012-1639-8"},{"key":"e_1_2_2_25_2","first-page":"51","article-title":"Traumatic dislocations of the patella: Problems related to treatment","volume":"75","author":"Savarese A.","year":"1990","journal-title":"Chir Organi Mov"},{"key":"e_1_2_2_26_2","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e318160740f"},{"key":"e_1_2_2_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-008-0713-9"},{"key":"e_1_2_2_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513507423"},{"key":"e_1_2_2_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507306161"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806314009669?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806314009669?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2014.11.040","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2014.11.040","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2014.11.040","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T08:54:31Z","timestamp":1773564871000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2014.11.040"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1,28]]},"references-count":28,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2015,6]]}},"alternative-id":["10.1016\/j.arthro.2014.11.040"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2014.11.040","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1,28]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Does Operative Treatment of First-Time Patellar Dislocations Lead to Increased Patellofemoral Stability? A Systematic Review of Overlapping Meta-analyses","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2014.11.040","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}