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Objectively quantified lower limb strength recovery in people treated surgically or non-surgically after patellar dislocation: A systematic review

Forde, C., Mortimer, C., Haddad, M. ORCID: 0000-0002-4822-5482, Hirani, S. P. ORCID: 0000-0002-1577-8806, Williams, M. A. and Keene, D. J. (2021). Objectively quantified lower limb strength recovery in people treated surgically or non-surgically after patellar dislocation: A systematic review. Physical Therapy in Sport, doi: 10.1016/j.ptsp.2021.06.003

Abstract

Objective: Synthesize evidence on objectively quantified lower limb strength recovery in people treated surgically or non-surgically after patellar dislocation.

Methods: MEDLINE, EMBASE, Cochrane Library, SPORTDiscus, PEDro, AMED and CINAHL databases were last searched on July 30th 2020 for randomized controlled trials and observational studies that objectively quantified lower limb strength in people (any age or sex) treated surgically or non-surgically after patellar dislocation.

Results: 24 studies were included (877 participants, median age 20.7). All assessed knee extension strength, 11 knee flexion strength, three hip abduction strength, two hip external rotation strength, and one hip flexion, extension, adduction, and internal rotation strength. One randomized controlled trial judged at high risk of bias and two cohort studies with methodological limitations compared lower limb strength recovery between surgically and non-surgically treated people, with conflicting findings. After surgery, median long-term (>8 months) knee extension strength was 82.5% (IQR 78.5-88.2; 13 studies) of the unaffected leg and knee flexion strength was 91.5% (IQR 90.7-96.9; five studies). After non-surgical treatment, median long-term knee extensor strength was 86% (IQR 79.3-87.4; four studies) and mean flexion strength ranged from 95.2-96.7% (two studies). Hip strength was always >90% (two studies). Two redislocations during eccentric isokinetic knee testing and knee pain during isokinetic knee extension testing were reported as adverse events.

Conclusions: Available evidence indicates that after patellar dislocation, knee extension strength deficits in the affected limb are frequently observed and can persist long term, but this remains uncertain due to the limitations of relevant included studies. Whether lower limb strength recovery differs between people treated surgically and those treated non-surgically after patellar dislocation also remains uncertain.

Publication Type: Article
Additional Information: This article has been published in Physical Therapy in Sport, Elsevier. DOI: https://doi.org/10.1016/j.ptsp.2021.06.003. © 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher Keywords: kneecap; patellofemoral; muscle; conservative
Subjects: R Medicine > RB Pathology
R Medicine > RC Internal medicine
Departments: School of Health Sciences > Healthcare Services Research & Management
Date available in CRO: 29 Jun 2021 10:22
Date deposited: 29 June 2021
Date of acceptance: 7 June 2021
Date of first online publication: 12 June 2021
URI: https://openaccess.city.ac.uk/id/eprint/26338
[img] Text - Accepted Version
This document is not freely accessible until 12 June 2022 due to copyright restrictions.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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