{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T12:44:44Z","timestamp":1787748284247,"version":"build-2784847793"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,7,10]],"date-time":"2014-07-10T00:00:00Z","timestamp":1404950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,7,10]],"date-time":"2014-07-10T00:00:00Z","timestamp":1404950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>We present the clinical results of a large consecutive, prospective, single\u2010clinic series of patients treated with medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar instability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included 224 patients undergoing MPFL reconstruction in a total of 240\u00a0knees between 2008 and 2011. Indication for surgery was two or more patellar dislocations and ADL limitations due to patella instability. Surgical procedure: A gracilis tendon autograft was fixed in drill holes in the medial edge of the patella and with screws at the femoral MPFL insertion point. Outcomes were evaluated with the Kujala Anterior Knee Pain Score and pain scores preoperatively and at follow\u2010up (12\u201360\u00a0months). Furthermore, incidences of re\u2010dislocations, subluxations and revision surgery were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Kujala score improved from 62.5 (17) to 80.4 (18) (<jats:italic>p<\/jats:italic> &lt; 0.001) at the 1\u2010year follow\u2010up. Pain during activity improved from 3.2 (2.6) to 1.3 (2.7) at 1 year (<jats:italic>p<\/jats:italic> &lt; 0.001). The revision rate was 2.8 %. Some degree of pain at the medial femoral condyle was seen in 30 % of the patients. The reconstruction was supplemented with a tibial tuberosity osteotomy in 23 % of cases. The outcome for these patients did not differ from that of patients with isolated MPFL reconstruction. Female gender BMI &gt;30, age &gt;30 years and grade 3\u20134 cartilage injury predisposed a poor subjective outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present study is the largest MPFL reconstruction patient material reported to date. MPFL reconstruction with a gracilis tendon autograft consistently normalised the patella stability and improved knee function. Moderate medial pain was seen. Age above 30, obesity, cartilage injury and female gender are predictors of a poor subjective outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-014-3164-5","type":"journal-article","created":{"date-parts":[[2014,7,9]],"date-time":"2014-07-09T10:05:53Z","timestamp":1404900353000},"page":"2458-2464","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":129,"title":["Clinical outcome after reconstruction of the medial patellofemoral ligament in patients with recurrent patella instability"],"prefix":"10.1002","volume":"22","author":[{"given":"Ditte","family":"Enderlein","sequence":"first","affiliation":[{"name":"Division of Sports Trauma Orthopaedic Department Aarhus University Hospital Tage Hansens Gade 2 8000 Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Division of Sports Trauma Orthopaedic Department Aarhus University Hospital Tage Hansens Gade 2 8000 Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svend Erik","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Division of Sports Trauma Orthopaedic Department Aarhus University Hospital Tage Hansens Gade 2 8000 Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Faun\u00f8","sequence":"additional","affiliation":[{"name":"Division of Sports Trauma Orthopaedic Department Aarhus University Hospital Tage Hansens Gade 2 8000 Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Lind","sequence":"additional","affiliation":[{"name":"Division of Sports Trauma Orthopaedic Department Aarhus University Hospital Tage Hansens Gade 2 8000 Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,7,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0968\u20100160(03)00006\u20101"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510373887"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511404883"},{"key":"e_1_2_6_5_1","doi-asserted-by":"crossref","unstructured":"BlondL HaugegaardM(2013) Combined arthroscopic deepening trochleoplasty and reconstruction of the medial patellofemoral ligament for patients with recurrent patella dislocation and trochlear dysplasia.Knee Surg Sports Traumatol Arthrosc. doi:10.1007\/s00167\u2010013\u20102422\u20102","DOI":"10.1007\/s00167-013-2422-2"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509353132"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010009\u20100929\u20104"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2007.08.005"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00211"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.85B6.13730"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0b013e31803035ae"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010009\u20100933\u20108"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01552649"},{"key":"e_1_2_6_14_1","first-page":"303","article-title":"Reconstruction of the medial patellofemoral ligament for patellar instability using a semitendinosus autograft","volume":"71","author":"Fernandez E","year":"2005","journal-title":"Acta Orthop Belg"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513480780"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2010.04.005"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503260788"},{"key":"e_1_2_6_18_1","doi-asserted-by":"crossref","unstructured":"FulkersonJP(1983) Anteromedialization of the tibial tuberosity for patellofemoral malalignment.Clin Orthop Relat Res176\u2013181","DOI":"10.1097\/00003086-198307000-00027"},{"key":"e_1_2_6_19_1","first-page":"423","article-title":"The measurement of the tibial tuberosity. 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