{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:19:57Z","timestamp":1792498797966,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T00:00:00Z","timestamp":1704326400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study is to systematically review and quantitatively analyse the clinical outcomes of combined derotational distal femoral osteotomy (D\u2010DFO) and medial patellofemoral ligament reconstruction (MPFL\u2010R) in the treatment of recurrent patellar dislocation (RPD) with increased femoral anteversion angle (FAA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was performed in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses) and AMSTAR (Assessing the Methodological Quality Of Systematic Reviews) Guidelines. PubMed, Embase, Web of Science and Cochrane Library databases were searched to identify studies reporting clinical outcomes of combined D\u2010DFO and MPFL\u2010R in RPD patients with increased FAA. Data on patient\u2010reported outcome measures, radiological parameters, patellar tracking as revealed by J\u2010sign and complications were extracted based on the inclusion criteria. The Methodological Index for Non\u2010Randomized Study score was used for quality assessment. Review Manager and R statistical software were used to perform the statistical analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven studies with a total of 569 knees in 553 patients were included. Patients were predominantly female (79%). The weighted mean of FAA decreased from 33.6\u00b0 to 13.0\u00b0 (weighted mean difference\u2009=\u200920.59; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.00001) after the combined procedure. Significant improvements (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.00001) were identified in the Lysholm score (weighted mean: 55.5 vs. 80.4), International Knee Documentation Committee (IKDC) score (weighted mean: 52.8 vs. 78.6) and Kujala score (weighted mean: 54.5 vs. 80.6). The incidence of residual J\u2010sign ranged from 14.3% to 38.3% with an overall pooled rate of 28.2% (95% confidence interval\u2009=\u200922.8%\u201333.6%). The overall redislocation rate was 1.1%. No patients experienced surgical site infection or bone nonunion. Two studies compared the clinical outcomes of MPFL\u2010R with and without D\u2010DFO. Compared with isolated MPFL\u2010R, the combined procedure yielded a better Lysholm score (weighted mean: 84.9 vs. 79.3, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), IKDC score (weighted mean: 84.1 vs. 79.9, <jats:italic>p<\/jats:italic>\u2009=\u20090.001), Kujala score (weighted mean: 84.3 vs. 79.4, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and a lower residual J\u2010sign rate (26\/97 [26.8%] vs. 44\/105 [41.9%], <jats:italic>p<\/jats:italic>\u2009=\u20090.02), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination of D\u2010DFO and MPFL\u2010R led to improved clinical outcomes and a low redislocation rate in patients with RPD and increased FAA. Additional D\u2010DFO can achieve more favourable results in subjective function and patellar tracking than isolated MPFL\u2010R in the setting of excessive FAA.<\/jats:p><jats:p><jats:bold>Level of Evidence<\/jats:bold>: Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12021","type":"journal-article","created":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T03:20:19Z","timestamp":1704338419000},"page":"151-166","source":"Crossref","is-referenced-by-count":32,"title":["Derotational distal femoral osteotomy improves subjective function and patellar tracking after medial patellofemoral ligament reconstruction in recurrent patellar dislocation patients with increased femoral anteversion: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"32","author":[{"given":"Daofeng","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Sports Medicine, Sports Medicine Service, Beijing Jishuitan Hospital Capital Medical University Beijing 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Jishuitan Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qizhen","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Sports Medicine Service, Beijing Jishuitan Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianzhong","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Sports Medicine Service, Beijing Jishuitan Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8329-1920","authenticated-orcid":false,"given":"Hui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Sports Medicine Service, Beijing Jishuitan Hospital Capital Medical University Beijing 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