{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:06:36Z","timestamp":1779192396123,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The surgical treatment of recurrent patellar dislocation (PRD) in adolescents faces particular difficulties, since the integrity of open growth plates may be compromised by standard surgical methods used in adults. This study aimed to review a series of adolescents with RPD who underwent robot\u2010assisted physeal\u2010sparing medial patellofemoral ligament (MPFL) reconstruction, compare the clinical results with those of a non\u2010robot\u2010assisted group, and measure the vertical distance between Sch\u00f6ttle point and the physis intraoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective clinical analysis included 55 adolescents with RPD who had no significant bone deformities and underwent MPFL reconstruction using either a robot\u2010assisted technique or a non\u2010robot\u2010assisted method between February 2019 to November 2023. Using a 2D intraopertive navigation system, the vertical distance between Sch\u00f6ttle point and the medial distal femoral physis was measured in the robot\u2010assisted group. The operation duration, the number of fluoroscopies and guide needle punctures were recorded in both groups. The anterior and distal tilt angles of the bone tunnel, as well as the distance between Sch\u00f6ttle point and the femoral insertion of the bone tunnel (DST), were measured using postoperative CT imaging in both groups. In addition to CT, MRI, and radiographic evaluations, the International Knee Documentation Committee (IKDC), Lysholm and Kujala scores were used to assess the clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean patient age was 13.1 years (range, 11\u201316 years). At a mean of 35.5 \u00b1 8.5 months postoperativel, all patients returned for evaluation. In the robot\u2010assisted group, the mean distance from the Sch\u00f6ttle point to medial femoral physis was 6.97\u2009\u00b1\u20091.92\u2009mm, with all Sch\u00f6ttle points positioned distal to the physis in every case. The IKDC, Lysholm and Kujala scores in the robot\u2010assisted group were significantly higher than those in the non\u2010robot\u2010assisted group three months post\u2010operatively (87.1\u2009\u00b1\u20096.1 vs. 82.9\u2009\u00b1\u20095.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011; 85.3\u2009\u00b1\u20095.7 vs. 81.1\u2009\u00b1\u20095.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007; 82.7\u2009\u00b1\u20096.0 vs. 77.5\u2009\u00b1\u20095.1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001); however, at the last follow\u2010up, there was no significant difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). No patients experienced recurrent patellar instability or physeal invasion following surgery, and significantly improved functional scores and patellar tilt angles were noted at the final follow\u2010up (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In the robot\u2010assisted group, the number of fluoroscopy and guide needle punctures was significantly lower (3.7\u2009\u00b1\u20090.5 vs. 10.3\u2009\u00b1\u20091.8; 1.1\u2009\u00b1\u20090.3 vs. 5.7\u2009\u00b1\u20091.1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with smaller anterior tilt angles (14.5\u2009\u00b1\u20091.7 vs. 16.6\u2009\u00b1\u20094.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044), larger distal tilt angles (13.8\u2009\u00b1\u20091.7 vs. 11.4\u2009\u00b1\u20091.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and shorter DST (2.00\u2009\u00b1\u20090.84 vs. 5.45\u2009\u00b1\u20091.74,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to the non\u2010robot\u2010assisted group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An anterodistal oblique bone tunnel can be safely used for anatomical MPFL reconstruction in skeletally immature patients, yielding good short\u2010term clinical outcomes. The robot\u2010assisted method is more accurate than the freehand method, requiring fewer intraoperative fluoroscopies and enabling faster early recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70294","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T13:08:08Z","timestamp":1752844088000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Two\u2010dimensional robot\u2010assisted physeal\u2010sparing medial patellofemoral ligament reconstruction can achieve favourable clinical outcomes for skeletally immature patients with recurrent patellar dislocation"],"prefix":"10.1002","volume":"12","author":[{"given":"Qiuzhen","family":"Liang","sequence":"first","affiliation":[{"name":"Sports Medicine Center, Honghui Hospital Xi'an Jiaotong University Xi'an Shaanxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zandong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Sports Medicine Center, Honghui Hospital Xi'an Jiaotong University Xi'an Shaanxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongwei","family":"Zhan","sequence":"additional","affiliation":[{"name":"Sports Medicine Center, Honghui Hospital Xi'an Jiaotong University Xi'an Shaanxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peidong","family":"Liu","sequence":"additional","affiliation":[{"name":"Sports Medicine Center, Honghui Hospital Xi'an Jiaotong University Xi'an Shaanxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaofan","family":"Liao","sequence":"additional","affiliation":[{"name":"Sports Medicine Center, Honghui Hospital Xi'an Jiaotong University Xi'an Shaanxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junxuran","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Imaging The Hospital of Xidian Group Xi'an Shaanxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongchao","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Digital Imaging, Honghui Hospital Xi'an Jiaotong University Xi'an Shaanxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Kang","sequence":"additional","affiliation":[{"name":"Sports Medicine Center, Honghui Hospital Xi'an Jiaotong University Xi'an Shaanxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Tian","sequence":"additional","affiliation":[{"name":"Sports Medicine Center, Honghui Hospital Xi'an Jiaotong University Xi'an Shaanxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Ren","sequence":"additional","affiliation":[{"name":"Sports Medicine Center, Honghui Hospital Xi'an Jiaotong University Xi'an Shaanxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Sports Medicine Center, Honghui Hospital Xi'an Jiaotong University Xi'an Shaanxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9648-3957","authenticated-orcid":false,"given":"Liang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Sports Medicine Center, Honghui Hospital Xi'an Jiaotong University Xi'an Shaanxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0000000000000145"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2009.11.004"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05447-w"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2013.06.014"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967113502638"},{"issue":"2","key":"e_1_2_13_7_1","first-page":"176","article-title":"Patellofemoral instability in skeletally immature athletes","volume":"95","author":"Hennrikus W","year":"2013","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06229-5"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510397174"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-4983-6"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508314410"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-011-1548-3"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-012-1593-5"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516677795"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jeo2.70063"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-005-0659-0"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506296415"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2009.12.020"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000165"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2021.01.041"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-011-1305-6"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-022-05592-x"}],"container-title":["Journal of Experimental Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70294","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jeo2.70294","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70294","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T11:30:15Z","timestamp":1779190215000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/jeo2.70294"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/jeo2.70294"],"URL":"https:\/\/doi.org\/10.1002\/jeo2.70294","archive":["Portico"],"relation":{},"ISSN":["2197-1153","2197-1153"],"issn-type":[{"value":"2197-1153","type":"print"},{"value":"2197-1153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2024-12-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70294"}}