{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T09:20:27Z","timestamp":1788254427663,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2011,7,6]],"date-time":"2011-07-06T00:00:00Z","timestamp":1309910400000},"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":[[2012,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Many surgical procedures have been proposed to treat recurrent patellar dislocation in children. In recent years, a more tailored approach considering the underlying pathology has been advocated. The aim of the study was to analyze a group of patients with recurrent patellofemoral instability after unsuccessful operative stabilization (Roux\u2010Goldthwait procedure, lateral release, medial reefing or in combination) in childhood and adolescence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 37 children and adolescents with recurrent patellofemoral instability despite previous surgery were analyzed retrospectively. Radiographic examination included AP and lateral views to assess patella alta and limb alignment. MRI was performed to evaluate trochlear dysplasia and tibial tubercle\u2010trochlear groove (TTTG) distance. As a control group, 23 age\u2010 and sex\u2010matched adolescents that were treated with a favorable outcome after medial reefing alone or combined with a Roux\u2010Goldthwait procedure were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Severe trochlear dysplasia (type B\u2013D according to Dejour) as detected on MRI scans was found significantly more often in the study group (89%) than in the control group (21%). No statistical difference of patellar height ratio (Insall\u2010Salvati index) and TTTG distance between the two groups could be found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Of the measured parameters, only the incidence of trochlear dysplasia was increased. Trochlear dysplasia therefore seems to be a major risk factor for failure of operative stabilization of recurrent patellofemoral instability in children and adolescents. The results in children are in consensus with the literature in adults that a more tailored operative therapy including reconstruction of the MPFL and trochleaplasty has to be considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Retrospective study, Level III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-011-1599-5","type":"journal-article","created":{"date-parts":[[2011,7,5]],"date-time":"2011-07-05T02:48:36Z","timestamp":1309834116000},"page":"822-828","source":"Crossref","is-referenced-by-count":76,"title":["Analysis of failed surgery for patellar instability in children with open growth plates"],"prefix":"10.1002","volume":"20","author":[{"given":"Manfred","family":"Nelitz","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> University of Ulm Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Theile","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> University of Ulm Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Dornacher","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> University of Ulm Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"W\u00f6lfle","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> University of Ulm Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiko","family":"Reichel","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> University of Ulm Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Lippacher","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> University of Ulm Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,7,6]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100838.2007.00730.x"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2006.08.022"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0968\u20100160(03)00006\u20101"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.90B7.20447"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2009.11.004"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510373581"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.89B9.19065"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010008\u20100652\u20105"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010009\u20100824\u2010y"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100030\u20101247840"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509353132"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354658801600308"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.92B1.22909"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00211"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.85B6.13730"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01552649"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0b013e31803035ae"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2005.12.005"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/bpo.0b013e31815b4dcf"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469\u20107580.2005.00400.x"},{"key":"e_1_2_6_22_2","first-page":"229","article-title":"Treatment of subluxation and dislocation of the patella in the child. 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