{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T01:20:47Z","timestamp":1784078447777,"version":"3.55.0"},"reference-count":50,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,9,6]],"date-time":"2013-09-06T00:00:00Z","timestamp":1378425600000},"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>A retrospective single\u2010centre study was focused on the long\u2010term outcome after different patello\u2010femoral (PF) realignment procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010nine patients treated for recurrent PF instability were examined after a mean post\u2010operative time of 22.5 years. Their 78\u00a0knees were divided into: non\u2010operated knees (NON\u2010OPERATED)\u2014<jats:italic>N<\/jats:italic> = 24, isolated proximal procedures (PROXIMAL)\u2014<jats:italic>N<\/jats:italic> = 22, isolated distal procedures (DISTAL)\u2014<jats:italic>N<\/jats:italic> = 10, and combined procedures (COMBINED)\u2014<jats:italic>N<\/jats:italic> = 22. PF\u2010related medical history together with clinical, subjective (KOOS and Kujala scores), and radiographic (Caton\u2013Deschamps PF height index, Kellgren\u2013Lawrence scale for tibio\u2010femoral OA, and Iwano classification for PF OA) evaluation was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PF re\u2010dislocation rate was comparable between PROXIMAL (36 %), DISTAL (20 %), and COMBINED (32 %). Isolated proximal procedures revealed less central patella positions (PROXIMAL 64 %; DISTAL 90 %; COMBINED 95 %) and more frequent PF apprehension test (PROXIMAL 82 %; DISTAL 40 %, COMBINED 50 %). KOOS and Kujala scores were similar in all three surgical subgroups, but significantly lower than in NON\u2010OPERATED. Patellas were positioned lower after DISTAL, 0.8 (0.5\u20131.0) or COMBINED, 0.9 (0.4\u20131.3). Kellgren\u2013Lawrence scores \u22652 were found in 42 % NON\u2010OPERATED, 37 % PROXIMAL, 70 % DISTAL, and 59 % COMBINED, whereas Iwano classification \u22652 was confirmed in 46 % NON\u2010OPERATED, 64 % PROXIMAL, 80 % DISTAL, and 86 % COMBINED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High PF re\u2010dislocation rates together with a very high incidence of PF OA indicate that PF realignment strategies used traditionally had failed to reach their long\u2010term expectations. The transfer of tibial tuberosity resulted in more constrained PF joints than isolated proximal procedures which allowed for more residual PF instability. Distal procedures additionally increased the likelihood for tibio\u2010femoral OA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-013-2637-2","type":"journal-article","created":{"date-parts":[[2013,9,5]],"date-time":"2013-09-05T01:55:48Z","timestamp":1378346148000},"page":"2747-2755","source":"Crossref","is-referenced-by-count":26,"title":["Long\u2010term clinical and radiographic outcome of patello\u2010femoral realignment procedures: a minimum of 15\u2010year follow\u2010up"],"prefix":"10.1002","volume":"22","author":[{"given":"Gregor","family":"Vivod","sequence":"first","affiliation":[{"name":"Medical Faculty University of Ljubljana Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Verdonk","sequence":"additional","affiliation":[{"name":"Faculty of Physiotherapy and Orthopedic Surgery Ghent University Ghent Belgium"},{"name":"Department of 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