{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T20:55:23Z","timestamp":1789937723653,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The multifactorial nature of patellofemoral instability requires a comprehensive assessment of the affected patients. While an association between tibial tuberosity (TT) torsion and patellofemoral instability is known, its specific effect has not yet been investigated. This study investigated the effect of TT torsion on patellofemoral instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study compared patients who underwent surgical intervention for patellofemoral instability and asymptomatic controls. TT torsion was measured in addition to other commonly assessed risk factors for patellofemoral instability using standardised computed tomography (CT) data of the lower extremities. The diagnostic performances of the assessed parameters were evaluated using receiver operating characteristic curve\u00a0analysis and odds ratios (ORs) were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The patellofemoral instability group consisted of 79 knees, compared to 72 knees in the asymptomatic control group. Both groups differed significantly in all assessed parameters (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), except for tibial torsion (n.s.). Among all parameters, TT torsion presented the best diagnostic performance for predicting patellar instability with an area under the curve of 0.95 (95% confidence interval [CI], 0.91\u20130.98;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). A cut\u2010off value of 17.7\u00b0 yielded a 0.87 sensitivity and 0.89 specificity to predict patellar instability (OR, 55.2; 95% CI, 20.5\u2013148.6;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among\u00a0the evaluated risk factors, TT torsion had the highest predictive value for patellofemoral instability. Patients with TT torsions\u2009\u2265\u200917.7\u00b0 showed a 55\u2010fold increased probability of patellofemoral instability. Therefore, TT torsion should be included in the assessment of patients with patellofemoral instability.<\/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\/ksa.12151","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T02:19:16Z","timestamp":1710901156000},"page":"1179-1186","source":"Crossref","is-referenced-by-count":17,"title":["Increased tibial tuberosity torsion has the greatest predictive value in patients with patellofemoral instability compared to other commonly assessed parameters"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8128-3927","authenticated-orcid":false,"given":"Lukas","family":"Jud","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Balgrist University Hospital University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Balgrist University Hospital University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lazaros","family":"Vlachopoulos","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Balgrist University Hospital University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan M.","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Balgrist University Hospital University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Ackermann","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Balgrist University Hospital University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro F.","family":"Fucentese","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Balgrist University Hospital University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-021-03947-4"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2021.02.018"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967118S00076"},{"issue":"3","key":"e_1_2_12_5_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 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