{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:44:24Z","timestamp":1792082664848,"version":"4.4.0"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"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":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this study was to compare mid\u2010 to long\u2010term clinical outcomes and redislocation rates after isolated medial patellofemoral ligament (MPFL) reconstruction in patients with and without borderline anatomical risk factors. It was hypothesized that isolated MPFL reconstruction would provide comparable outcomes regardless of borderline anatomical abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective comparative study was performed on 51 patients (55 knees) treated with isolated MPFL reconstruction for recurrent patellar instability between 2013 and 2023. Patients were divided into a standard group (Caton\u2013Deschamps Index [CDI]\u2009&lt;\u20091.2, tibial tubercle\u2013trochlear groove [TT\u2013TG]\u2009&lt;\u200920\u2009mm, absent or Type A trochlear dysplasia) and a borderline group (CDI 1.2\u20131.4, TT\u2013TG 20\u201324\u2009mm and\/or Dejour Type B\u2013D trochlear dysplasia without explosive J\u2010sign or large trochlear spur). Clinical outcomes were assessed using Knee injury and Osteoarthritis Outcome Score (KOOS), Kujala, Tegner and Visual Analogue Scale (VAS) scores at a mean follow\u2010up of 7.9\u2009\u00b1\u20093.9 years. Redislocations and complications were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010five knees were included in the standard group and 30 in the borderline group. Both groups showed significant improvement in all clinical scores from baseline to final follow\u2010up (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for all). No significant differences were observed between groups at final follow\u2010up in KOOS (88.9\u2009\u00b1\u200910.3 vs. 86.1\u2009\u00b1\u20099.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.159), Kujala (85.3\u2009\u00b1\u200918.8 vs. 86.9\u2009\u00b1\u200910.3;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.713), Tegner (4.0\u2009\u00b1\u20091.1 vs. 3.9\u2009\u00b1\u20091.3;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.765) or VAS scores (1.6\u2009\u00b1\u20091.1 vs. 2.1\u2009\u00b1\u20091.8;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.260). Redislocation rates were comparable between groups (4.0% vs. 6.7%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.0). Within the borderline group, the cumulative burden of anatomical risk factors did not negatively affect outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Isolated MPFL reconstruction provides reliable and durable mid\u2010 to long\u2010term outcomes in carefully selected patients with borderline anatomical risk factors, with clinical results and redislocation rates comparable to those observed in standard patients. These findings support a patient\u2010specific surgical approach, suggesting that additional bony procedures should be reserved for clearly pathological anatomical abnormalities rather than routinely performed in borderline cases.<\/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\/jeo2.70928","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:04:00Z","timestamp":1790697840000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparable clinical outcomes and redislocation rates after isolated medial patellofemoral ligament reconstruction in patients with and without borderline anatomical risk factors for patellar instability"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4464-2254","authenticated-orcid":false,"given":"Alessio","family":"Maione","sequence":"first","affiliation":[{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini\u2010CTO, 1\u00b0 Clinica Ortopedica Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0770-1115","authenticated-orcid":false,"given":"Simone","family":"Romano","sequence":"additional","affiliation":[{"name":"Residency Program in Orthopedics and Traumatology University of Milan Milan Italy"},{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini\u2010CTO, Traumatologia Sportiva Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierrenzo","family":"Pozzi","sequence":"additional","affiliation":[{"name":"Residency Program in Orthopedics and Traumatology University of Milan Milan Italy"},{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini\u2010CTO, Ortopedia Traumatologia d'Urgenza Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1206-0572","authenticated-orcid":false,"given":"Matteo D.","family":"Parmigiani","sequence":"additional","affiliation":[{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini\u2010CTO, 1\u00b0 Clinica Ortopedica Milan Italy"},{"name":"Residency Program in Orthopedics and Traumatology University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Menon","sequence":"additional","affiliation":[{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini\u2010CTO, 1\u00b0 Clinica Ortopedica Milan Italy"},{"name":"Department of Clinical and Community Sciences, Graduate School of Health Statistics and Biometrics University of Milan Milan Italy"},{"name":"Department of Biomedical Sciences for Health, Laboratory of Applied Biomechanics University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Ferrua","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, Laboratory of Applied Biomechanics University of Milan Milan Italy"},{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini\u2010CTO, Week\u2010Surgery Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Calanna","sequence":"additional","affiliation":[{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini\u2010CTO, 1\u00b0 Clinica Ortopedica Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Compagnoni","sequence":"additional","affiliation":[{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini\u2010CTO, 1\u00b0 Clinica Ortopedica Milan Italy"},{"name":"Department of Biomedical, Surgical and Dental Sciences University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Usellini","sequence":"additional","affiliation":[{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini\u2010CTO, Traumatologia Sportiva Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Mambretti","sequence":"additional","affiliation":[{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini\u2010CTO, Traumatologia Sportiva Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Berruto","sequence":"additional","affiliation":[{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini\u2010CTO, Traumatologia Sportiva Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro S.","family":"Randelli","sequence":"additional","affiliation":[{"name":"ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini\u2010CTO, 1\u00b0 Clinica Ortopedica Milan Italy"},{"name":"Department of Biomedical Sciences for Health, Laboratory of Applied Biomechanics University of Milan Milan Italy"},{"name":"Department of Biomedical, Surgical and Dental Sciences University of Milan Milan Italy"},{"name":"Department of Biomedical Sciences for Health, Research Center for Adult and Pediatric Rheumatic Diseases (RECAP\u2010RD) University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jeo2.70213"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516663498"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12637"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12620"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-021-00392-5"},{"key":"e_1_2_15_7_1","first-page":"385","article-title":"[Method of measuring the height of the patella]","volume":"55","author":"Caton J","year":"1989","journal-title":"Acta Orthop Belg"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2013.06.014"},{"key":"e_1_2_15_9_1","first-page":"128","article-title":"MPFL reconstruction: indications and results","volume":"91","author":"Dall'oca 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