{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:48:50Z","timestamp":1792158530206,"version":"4.4.0"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare postoperative complications, rehabilitation outcomes, and health care utilization in children\u00a0undergoing primary medial patellofemoral ligament reconstruction for patellofemoral instability with and without a pre\u2010existing mental illness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The TriNetX U.S. Collaborative Network was queried to identify patients younger than 18 years old undergoing medial patellofemoral ligament reconstruction for patellar instability in the United States between 2000 and 2020. Patients were then separated into those with a pre\u2010existing mental illness (PMI Group) and those without (Control Group). After propensity score matching for patient demographics, chronic pain, and obesity, postoperative complication rates, rehabilitation outcomes, and health care utilization of both groups were compared across 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After propensity score matching, each group consisted of 223 patients for a total cohort of 446 patients. The PMI Group\u00a0showed significantly greater rates of postoperative knee pain (51.5% vs 41.0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.004, risk ratios (RR): 1.40), opioid analgesic use (42.2% vs 31.4%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.018, RR: 1.34), nonopioid analgesic use (34.5% vs 22.0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.006, RR: 1.27), emergency department visits (22.0% vs 4.9%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001, RR: 4.46), and physical therapy treatment sessions (61.4% vs 51.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.028, RR: 1.20).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children with pre\u2010existing mental illness exhibit significantly greater rates of persistent knee pain, higher opioid consumption, and increased health care utilization following medial patellofemoral ligament reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ars2.70054","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T01:40:59Z","timestamp":1784252459000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of Psychiatric Comorbidities on Postoperative Outcomes Following Pediatric Medial Patellofemoral Ligament 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U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3157-4739","authenticated-orcid":false,"given":"Amit","family":"Momaya","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of Alabama at Birmingham  Birmingham Alabama U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5877-4162","authenticated-orcid":false,"given":"Kevin A.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of Alabama at Birmingham  Birmingham Alabama 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