Heterogeneity in the use of osseous risk factors and limited use of relevant patient-reported outcome measurements in studies investigating treatment of patellar dislocation: A scoping review

PURPOSE: The treatment of patellar dislocation is tailored based on the presence or absence of osseous risk factors. The purpose of this scoping review was to investigate whether existing research addresses patient differences by mapping the use of osseous risk factors and patient-reported outcome measures (PROMs) in studies investigating the treatment of patellar dislocation.

METHODS: This study was a scoping review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews. Studies published between 1 January 2013 and 3 April 2023 were included if they investigated the treatment of patellar dislocation and registered osseous risk factor(s). Case series with fewer than 10 patients, reviews and meta-analyses were excluded.

RESULTS: A total of 8923 records were identified, of which 1007 articles underwent full-text screening, and 300 met the inclusion criteria. A twofold increase in articles investigating patellar dislocation treatment was observed between the years 2013 and 2022. This review identified 176 osseous risk factors and 56 PROMs. Among the included articles, 131 (44%) utilized osseous risk factors as in- or exclusion criteria, and 26 (9%) employed a PROM specifically developed for patellar instability evaluation. The most frequently investigated treatment was medial patellofemoral ligament reconstruction (231 articles, 77%), followed by tibial tubercle osteotomies (87 articles, 29%).

CONCLUSION: There is considerable heterogeneity among studies investigating the treatment of patellar dislocation. Less than half of studies define the patient population according to osseous risk factors, and only 1 in 10 studies use a PROM designed for patellar dislocation. This complicates the evaluation of treatment effects in relation to osseous risk factors.

LEVEL OF EVIDENCE: Level III.