{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:22:00Z","timestamp":1789690920164,"version":"4.0.1"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"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":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the mid\u2010to\u2010 long\u2010term clinical and radiological outcomes of isolated medial patellofemoral ligament reconstruction (MPFL\u2010R) using a high\u2010strength suture tape (HSST) construct in patients with recurrent patellar instability and no major osseous risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients treated with isolated MPFL\u2010R using HSST and a single knotless femoral anchor between 2015 and 2021 were retrospectively reviewed. Inclusion criteria were recurrent lateral patellar instability (\u22652 dislocations or symptomatic subluxations) refractory to nonoperative treatment and a minimum postoperative follow\u2010up of 60 months. Patients requiring concomitant bony realignment or presenting with major anatomic risk factors (e.g., high\u2010grade trochlear dysplasia, severe patella alta, tibial tubercle\u2013trochlear groove distance &gt;20\u2009mm) were excluded. Clinical outcomes were assessed with the International Knee Documentation Committee (IKDC) subjective score, Kujala score and visual analogue scale (VAS) for pain. Patellar tilt was measured on axial magnetic resonance imaging (MRI). Postoperative instability events, complications and reoperations were recorded. Clinically meaningful improvements were assessed using minimal clinically important difference (MCID) and patient\u2010acceptable symptomatic state (PASS) thresholds. Kaplan\u2013Meier survival analysis was performed to estimate 5\u2010year survivorship free from redislocation (primary endpoint) and any postoperative instability (secondary endpoint). Postoperative instability was defined as clinically documented redislocation or symptomatic subluxation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty\u2010one patients (mean age 20.8 years; 31.4% female) were included. At a mean follow\u2010up of 79.4\u2009\u00b1\u200914.3 months, one redislocation (1.2%) and two subluxations (2.5%) occurred. Five\u2010year survivorship free from redislocation was 98.8% (95% confidence interval [CI], 96.4%\u2013100%), and survivorship free from any postoperative instability was 96.3% (95% CI, 92.2%\u2013100%). All patient\u2010reported outcome measures improved significantly from baseline to final follow\u2010up (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Ninety\u2010six percent of patients achieved the PASS threshold for IKDC (95% CI, 89.7%\u201398.7%), whereas PASS attainment for the Kujala score ranged from 74% to 86% depending on the applied cut\u2010off. Radiologically, patellar tilt improved substantially on MRI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Postoperative complications were infrequent and manageable, including five cases of arthrofibrosis (requiring manipulation under anaesthesia), one deep infection (treated with arthroscopic debridement) and three cases of implant\u2010related bursitis at the femoral fixation site.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Isolated MPFL reconstruction using an HSST construct provided durable patellar stability and significant functional improvement at a minimum 5\u2010year follow\u2010up. This technique represents a reliable mid\u2010to\u2010long\u2010term option for isolated MPFL\u2010R in appropriately selected patients, especially when graft harvest morbidity and patellar bone preservation are concerns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70466","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T13:08:55Z","timestamp":1779800935000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Durable patellar stability and high patient\u2010reported success at minimum 5\u2010year follow\u2010up after isolated suture tape MPFL reconstruction"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0926-5879","authenticated-orcid":false,"given":"Tunay","family":"Erden","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Traumatology Istanbul Health and Technology University Istanbul Turkey"},{"name":"FIFA Medical Center of Excellence, Ac\u0131badem Fulya Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muzaffer","family":"A\u011f\u0131r","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Ac\u0131badem Maslak Hospital Ac\u0131badem Mehmet Ali Ayd\u0131nlar University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmut Enes","family":"Kayaalp","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology Fatih Sultan Mehmet Training and Research Hospital University of Health Sciences Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berkin","family":"Toker","sequence":"additional","affiliation":[{"name":"FIFA Medical Center of Excellence, Ac\u0131badem Fulya Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6mer","family":"Ta\u015fer","sequence":"additional","affiliation":[{"name":"FIFA Medical Center of Excellence, Ac\u0131badem Fulya Hospital Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"3755","DOI":"10.1007\/s00167-016-4272-1","article-title":"Origin and insertion of the medial patellofemoral ligament: a systematic review of anatomy","volume":"25","author":"Aframian A","year":"2017","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_13_3_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jcot.2024.102883","article-title":"Medial patellofemoral ligament reconstruction using synthetic suture tape: a systematic review of biomechanical and clinical outcomes","volume":"61","author":"Akhtar M","year":"2025","journal-title":"J Clin Orthop Trauma"},{"key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"3869","DOI":"10.1007\/s00167-016-4365-x","article-title":"Results of medial patellofemoral ligament reconstruction compared with trochleoplasty plus individual extensor apparatus balancing in patellar instability caused by severe trochlear dysplasia: a systematic review and meta\u2010analysis","volume":"25","author":"Balcarek P","year":"2017","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"2920","DOI":"10.1007\/s00167-018-4833-6","article-title":"Reconstruction of the medial patellotibial ligament results in favorable clinical outcomes: a systematic review","volume":"26","author":"Baumann CA","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_13_6_1","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.knee.2023.07.003","article-title":"Isolated medial patellofemoral reconstruction outcomes: a systematic review and meta\u2010analysis","volume":"44","author":"Castagno C","year":"2023","journal-title":"Knee"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2025.104450"},{"key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"e1197","DOI":"10.1016\/j.eats.2020.04.020","article-title":"Medial patellofemoral ligament reconstruction using FiberTape and Knotless SwiveLock anchors","volume":"9","author":"Ishibashi Y","year":"2020","journal-title":"Arthrosc Tech"},{"key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1016\/j.arthro.2023.01.098","article-title":"Complication rates after medial patellofemoral ligament reconstruction range from 0% to 32% with 0% to 11% recurrent instability: a systematic review","volume":"39","author":"Jackson GR","year":"2023","journal-title":"Arthroscopy"},{"key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"3225","DOI":"10.1007\/s00590-023-03559-1","article-title":"Medial patellofemoral ligament reconstruction using patella bone tunnel techniques with or without implants. A systematic review of outcomes and complications","volume":"33","author":"Kalinterakis G","year":"2023","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.knee.2015.07.002","article-title":"Minimally invasive medial patellofemoral ligament reconstruction for patellar instability using an artificial ligament: a two year follow\u2010up","volume":"23","author":"Khemka A","year":"2016","journal-title":"Knee"},{"key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"3082","DOI":"10.1016\/j.arthro.2018.06.052","article-title":"Which technique is better for treating patellar dislocation? A systematic review and meta\u2010analysis","volume":"34","author":"Lee DY","year":"2018","journal-title":"Arthroscopy"},{"key":"e_1_2_13_13_1","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/j.arthro.2017.11.027","article-title":"Graft choice in isolated medial patellofemoral ligament reconstruction: a systematic review with meta\u2010analysis of rates of recurrent instability and patient\u2010reported outcomes for autograft, allograft, and synthetic options","volume":"34","author":"McNeilan RJ","year":"2018","journal-title":"Arthroscopy"},{"key":"e_1_2_13_14_1","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1186\/s13018-021-02383-9","article-title":"Isolated medial patellofemoral ligament reconstruction for recurrent patellofemoral instability: analysis of outcomes and risk factors","volume":"16","author":"Migliorini F","year":"2021","journal-title":"J Orthop Surg"},{"key":"e_1_2_13_15_1","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.arthro.2023.06.042","article-title":"The value of minimal clinically important difference, substantial clinical benefit, and patient\u2010acceptable symptomatic state for commonly used patient\u2010reported outcomes in recurrent patellar instability patients after medial patellofemoral ligament reconstruction and tibial tubercle transfer","volume":"40","author":"Qiao Y","year":"2024","journal-title":"Arthroscopy"},{"key":"e_1_2_13_16_1","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1016\/j.arthro.2019.12.027","article-title":"Patellofemoral contact pressure for medial patellofemoral ligament reconstruction using suture tape varies with the knee flexion angle: a biomechanical evaluation","volume":"36","author":"Sakamoto Y","year":"2020","journal-title":"Arthroscopy"},{"key":"e_1_2_13_17_1","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1186\/s12891-024-07722-5","article-title":"Results of medial patellofemoral ligament reconstruction with and without tibial tubercle osteotomy in patellar instability: a systematic review and single\u2010arm meta\u2010analysis","volume":"25","author":"Su P","year":"2024","journal-title":"BMC Musculoskelet Disord"},{"key":"e_1_2_13_18_1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3390\/biomimetics10010065","article-title":"Medial patellofemoral ligament repair with suture tape augmentation can yield good midterm clinical outcomes regardless of skeletal maturity and joint laxity","volume":"10","author":"Takada S","year":"2025","journal-title":"Biomimetics"},{"key":"e_1_2_13_19_1","first-page":"75","article-title":"The use of synthetic graft for MPFL reconstruction surgery: a systematic review of the clinical outcomes","volume":"11","author":"Tanos P","year":"2023","journal-title":"Med Sci"},{"key":"e_1_2_13_20_1","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.jos.2018.11.018","article-title":"Biomechanical analysis of medial patellofemoral ligament reconstruction: FiberTape\u00ae with knotless anchors versus a semitendinosus tendon autograft with soft anchors","volume":"24","author":"Tsushima T","year":"2019","journal-title":"J Orthop Sci"},{"key":"e_1_2_13_21_1","doi-asserted-by":"crossref","DOI":"10.1177\/23259671241241537","article-title":"Biomechanical properties and kinematics of medial patellofemoral ligament reconstruction: a systematic review","volume":"12","author":"Walsh JM","year":"2024","journal-title":"Orthop J Sports Med"},{"key":"e_1_2_13_22_1","doi-asserted-by":"crossref","first-page":"e661","DOI":"10.1016\/j.asmr.2021.12.009","article-title":"The minimal clinically important difference, substantial clinical benefit, and patient\u2010acceptable symptomatic state after medial patellofemoral ligament reconstruction","volume":"4","author":"Walsh JM","year":"2022","journal-title":"Arthrosc Sports Med Rehabil"},{"key":"e_1_2_13_23_1","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1111\/os.12945","article-title":"Medial patellofemoral ligament reconstruction using suture tape for patellofemoral joint instability","volume":"13","author":"Xu J","year":"2021","journal-title":"Orthopaedic Surgery"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70466","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ksa.70466","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70466","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T13:08:58Z","timestamp":1779800938000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.70466"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":22,"alternative-id":["10.1002\/ksa.70466"],"URL":"https:\/\/doi.org\/10.1002\/ksa.70466","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"assertion":[{"value":"2026-02-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ksa.70466"}}