{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:01:55Z","timestamp":1789844515691,"version":"4.0.1"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":47,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"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":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>We hypothesized that patients undergoing anterior cruciate ligament reconstruction (ACL\u2010R) are more likely to develop patellofemoral osteoarthritis (PFOA) than those with an ACL injury managed non\u2010surgically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Systematic review and Meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature review and meta\u2010analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analysis (PRISMA) guidelines. Studies reporting PFOA assessment by radiographic or magnetic resonance imaging after ACL\u2010R compared to non\u2010surgical treatment of ACL injury were included. Studies involving individuals with concurrent other ligamentous or chondral injuries treated surgically were excluded to minimize bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of six studies were included in the systematic review. The meta\u2010analysis demonstrated that patients undergoing ACL\u2010R had a significantly higher likelihood of developing PFOA compared to those who received non\u2010surgical treatment after ACL injury (odds ratio [OR]\u2009=\u20092.21; 95% confidence interval [CI]: 1.13\u22124.35;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Patients who underwent ACL\u2010R with bone\u2013patellar tendon\u2013bone (BPTB) autograft exhibited a significantly higher prevalence of PFOA than those with HT autograft (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Moreover, male patients exhibited a higher association with PFOA than females in both the ACL\u2010R (34.38% vs. 7.77%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and non\u2010surgical ACL injury groups (28.13% vs. 0.97%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ACL\u2010R significantly increases the likelihood of PFOA compared to non\u2010surgical ACL treatment, especially when using BPTB autografts. Male patients demonstrated a higher association with PFOA in both groups. Targeted preventive strategies, including optimized graft selection and enhanced rehabilitation protocols, are crucial for reducing the risk of PFOA following ACL\u2010R.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70697","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T10:01:15Z","timestamp":1779098475000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of patellofemoral osteoarthritis between patients treated surgically or non\u2010surgically following anterior cruciate ligament injuries: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3566-5778","authenticated-orcid":false,"given":"Domenico","family":"Franco","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USA"},{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery Fondazione Policlinico Universitario Campus Bio\u2010Medico Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Bumberger","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USA"},{"name":"Department of Orthopaedic and Trauma Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim University of Heidelberg Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chilan B. 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