{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:20:00Z","timestamp":1792498800128,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:00:00Z","timestamp":1715731200000},"content-version":"vor","delay-in-days":0,"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":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to\u00a0investigate whether double\u2010level (femur\u2009+\u2009tibia) derotational osteotomy is superior to single\u2010level femoral derotational osteotomy for recurrent patellar dislocation with severe femoral and tibial rotational deformities (femoral anteversion &gt;30\u00b0 and external tibial torsion &gt;30\u00b0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between January 2015 and June 2020, a total of 115 knees with recurrent patellar dislocation treated with combined medial patellofemoral ligament reconstruction (MPFL\u2010R) and derotational osteotomies were evaluated after a minimum follow\u2010up of 2 years. Among these cases, 15 knees that underwent double\u2010level derotational osteotomy were included in the double\u2010level group, which was propensity\u2010matched in a 1:2 ratio to a single\u2010level group of patients who underwent single\u2010level femoral derotational osteotomy (30 knees). The clinical and radiological outcomes were evaluated and compared between the groups. Furthermore, the foot progression angle was measured preoperatively and 2 years after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patient\u2010specific variables did not differ significantly between the double\u2010\u00a0and the single\u2010level groups after propensity score matching. The postoperative mean foot progression angle was significantly lower in the double\u2010level group\u00a0than in the single\u2010level group (9\u00b0\u2009\u00b1\u20098\u00b0 vs. 15\u00b0\u2009\u00b1\u200911\u00b0; <jats:italic>p<\/jats:italic>\u2009=\u20090.014); however, there were no statistically significant differences between the groups in terms of any other clinical and radiological assessments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For patients with severe femoral and tibial torsional deformities (femoral anteversion &gt;30\u00b0 and external tibial torsion &gt;30\u00b0), the double\u2010level derotational osteotomy is superior to single\u2010level osteotomy in maintaining normal foot progression angle, but it does not show an advantage in terms of patient\u2010reported outcomes, radiological results\u00a0and redislocation rate at minimum 2 years of follow\u2010up. Furthermore, concomitant excessive external tibial torsion (&gt;30\u00b0) did not have an adverse effect on clinical outcomes in patients who underwent derotational distal femoral osteotomy with MPFL\u2010R due to excessive femoral anteversion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level III.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12246","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T01:16:35Z","timestamp":1715822195000},"page":"2248-2257","source":"Crossref","is-referenced-by-count":12,"title":["Surgical treatment for recurrent patellar dislocation with severe torsional deformities:\u00a0Double\u2010level derotational osteotomy may not have a clear advantage over single\u2010level derotational osteotomy in improving clinical and radiological outcomes"],"prefix":"10.1002","volume":"32","author":[{"given":"Zhijun","family":"Zhang","sequence":"first","affiliation":[{"name":"Sports Medicine Service, Beijing Jishuitan Hospital Capital Medical University Beijing Xi Cheng District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daofeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Sports Medicine Service, Beijing Jishuitan Hospital Capital Medical University Beijing Xi Cheng District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menglinqian","family":"Di","sequence":"additional","affiliation":[{"name":"Sports Medicine Service, Beijing Jishuitan Hospital Capital Medical University Beijing Xi Cheng District China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Zheng","sequence":"additional","affiliation":[{"name":"Sports Medicine Service, Beijing Jishuitan Hospital Capital Medical University Beijing Xi Cheng District 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":"Sports Medicine Service, Beijing Jishuitan Hospital Capital Medical University Beijing Xi Cheng District 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