{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T20:25:16Z","timestamp":1789590316900,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,4,2]],"date-time":"2013-04-02T00:00:00Z","timestamp":1364860800000},"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":[[2014,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of the present study was to retrospectively investigate the development of patellofemoral osteoarthritis after the historical Insall's proximal realignment for patellar stabilisation in patients with recurrent patellar dislocation. Furthermore, risk factors for recurrent patellar dislocation and for patellofemoral osteoarthritis development were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010two patients underwent patellofemoral stabilising surgery by the historic Insall's proximal realignment; they were evaluated with a mean follow\u2010up period of 52\u00a0months. Plain radiography was used to document osteoarthritic changes by using the Iwano classification. MRIs obtained at the latest follow\u2010up were evaluated for patellofemoral cartilage lesions. Univariate and multivariate logistic regression analyses were performed to evaluate the influence of trochlear dysplasia, tibial tubercle\u2013trochlear groove distance and patellar height on redislocation. Pearson's <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> and the Spearman's correlation tests were used to assess a possible correlation between trochlear dysplasia and patellar dislocation, as well as between instability and development of patellofemoral osteoarthritis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At the latest follow\u2010up, plain radiographs showed a significant increase in patellofemoral osteoarthritis (grades II\u2013IV according to the Iwano classification) in 18 patients (43 %) compared with 4 patients (10 %) at the time of surgery (<jats:italic>P<\/jats:italic> = 0.001). Patellofemoral cartilage lesions (grades II\u2013IV) were detected in 18 patients (43 %) on MRI. Nine patients (21 %) had at least one incidence of redislocation at follow\u2010up. Estimated redislocation\u2010associated risk factors could not be determined. Trochlear dysplasia had a significant impact on patellofemoral osteoarthritis development (<jats:italic>P<\/jats:italic> = 0.001), whereas recurrent patellar instability had none (n.s.).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Insall's proximal realignment technique leads to a significant progression of patellofemoral osteoarthritis. No risk factors for redislocation could be found; however, the presence of trochlear dysplasia did correlate with patellofemoral osteoarthritis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-013-2485-0","type":"journal-article","created":{"date-parts":[[2013,4,1]],"date-time":"2013-04-01T03:22:03Z","timestamp":1364786523000},"page":"2623-2628","source":"Crossref","is-referenced-by-count":20,"title":["Patellofemoral osteoarthritis after Insall's proximal realignment for recurrent patellar dislocation"],"prefix":"10.1002","volume":"22","author":[{"given":"Karl F.","family":"Sch\u00fcttler","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Rheumatology University Hospital Marburg Baldingerstrasse 35043 Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Struewer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rheumatology University Hospital Marburg Baldingerstrasse 35043 Marburg Germany"},{"name":"Department of Trauma Hand and Reconstructive Surgery University Hospital Marburg Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip P.","family":"Roessler","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rheumatology University Hospital Marburg Baldingerstrasse 35043 Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Gesslein","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery N\u00fcrnberg Hospital N\u00fcrnberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marga B.","family":"Rominger","sequence":"additional","affiliation":[{"name":"Department of Radiology University Hospital Marburg Marburg 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