{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:25:16Z","timestamp":1770744316266,"version":"3.49.0"},"reference-count":50,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,3,27]],"date-time":"2019-03-27T00:00:00Z","timestamp":1553644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,3,27]],"date-time":"2019-03-27T00:00:00Z","timestamp":1553644800000},"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":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Generalized joint hypermobility (GJH) has frequently been described as a risk factor for patellofemoral instability; however, only a few primary research studies have demonstrated any evidence of a relationship. The primary purpose of this study was to determine if isolated proximal soft tissue stabilization for patellofemoral instability is as successful in patients with GJH compared those without, as measured by disease\u2010specific quality\u2010of\u2010life (QOL), symptom scores and functional outcomes. The secondary purpose was to determine if clinical and patient\u2010reported outcomes were influenced by patient demographic factors in the presence of joint hypermobility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 2009 and 2014, data were collected on 174\/193\u00a0knees (92% follow\u2010up) following an isolated medial patellofemoral ligament reconstruction (MPFL\u2010R). Patients with a Beighton score of 4 or greater were classified as positive for GJH, and any score of 3 or less was classified as negative. Pre\u2010 and post\u2010operative Banff Patella Instability Instrument (BPII) scores were compared using a two\u2010sample <jats:italic>t<\/jats:italic> test to determine the influence of GJH on QOL. The relationship between the Beighton score, and demographic and clinical factors was explored using correlational analysis. Functional testing including balance and single\u2010leg hop testing was conducted 1 and 2 years post\u2010operatively. Limb symmetry and mean limb\u2010to\u2010limb performance differences were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this cohort of isolated MPFL reconstructions, 55.1% had a positive Beighton score. There were seven surgical failures (3.6%). There was no evidence of a relationship between a positive Beighton score and pre\u2010operative BPII scores, post\u2010operative BPII scores or post\u2010operative symptom scores. GJH did not correlate significantly with any post\u2010operative functional testing measures. A positive Beighton score was inversely related to patient age and more prevalent in females.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study determined that the presence of GJH did not influence disease\u2010specific quality of life, physical symptom score or functional outcomes following MPFL reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-019-05489-0","type":"journal-article","created":{"date-parts":[[2019,3,27]],"date-time":"2019-03-27T12:56:11Z","timestamp":1553691371000},"page":"3660-3667","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Generalized joint hypermobility does not influence clinical outcomes following isolated MPFL reconstruction for patellofemoral instability"],"prefix":"10.1002","volume":"27","author":[{"given":"Laurie Anne","family":"Hiemstra","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Banff Sport Medicine PO Box 1300 T1L 1B3 Banff AB Canada"},{"name":"<!--<label>2<\/label>--> Department of Surgery University of Calgary Calgary Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5940-5000","authenticated-orcid":false,"given":"Sarah","family":"Kerslake","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Banff Sport Medicine PO Box 1300 T1L 1B3 Banff AB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathalie","family":"Kupfer","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Faculty of Medicine &amp; Dentistry University of Alberta Edmonton Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark R.","family":"Lafave","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Department of Health &amp; Physical Education Mount Royal University Calgary Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,27]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/36.12.1324"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.51B3.444"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.32.5.413"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsams.2013.11.001"},{"key":"e_1_2_9_6_2","first-page":"281","article-title":"Intrarater and interrater reliability of the Beighton and Horan Joint Mobility Index","volume":"38","author":"Boyle KL","year":"2003","journal-title":"J Athl Train"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.40B4.664"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.46B1.40"},{"key":"e_1_2_9_9_2","unstructured":"CastoriM TinkleB LevyH GrahameR MalfaitF HakimAA framework for the classification of joint hypermobility and related conditions.Am J Med Genet C Semin Med Genet(2017)10.1002\/ajmg.c.3153928306229"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2010.02.005"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.30435"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1997.02170470023005"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/1757-1146-5-1"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2010.04.005"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.phm.0000200390.67408.f0"},{"key":"e_1_2_9_16_2","first-page":"692","article-title":"Joint hypermobility\u2014clinical aspects","volume":"64","author":"Grahame R","year":"1971","journal-title":"Proc R Soc Med"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-006-0045-6"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/878107"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967116646085"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513487981"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516635626"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.94B9.28738"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.94B12.29562"},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780230914"},{"key":"e_1_2_9_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-015-0611-5"},{"key":"e_1_2_9_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kem290"},{"key":"e_1_2_9_27_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.26.5.419"},{"key":"e_1_2_9_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516644605"},{"key":"e_1_2_9_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001250"},{"key":"e_1_2_9_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/32.2.116"},{"key":"e_1_2_9_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514529640"},{"key":"e_1_2_9_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-014-2424-9"},{"key":"e_1_2_9_33_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1970.03170260032007"},{"key":"e_1_2_9_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2006.04.090"},{"key":"e_1_2_9_35_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510364838"},{"key":"e_1_2_9_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsams.2007.05.005"},{"key":"e_1_2_9_37_2","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20060143"},{"key":"e_1_2_9_38_2","first-page":"798","article-title":"Are diagnostic criteria for general joint hypermobility and benign joint hypermobility syndrome based on reproducible and valid tests? 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