{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:59:25Z","timestamp":1790740765797,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,4,9]],"date-time":"2020-04-09T00:00:00Z","timestamp":1586390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,4,9]],"date-time":"2020-04-09T00:00:00Z","timestamp":1586390400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,4,9]],"date-time":"2020-04-09T00:00:00Z","timestamp":1586390400000},"content-version":"vor","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":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The primary purpose of this study was to determine if isolated medial patellofemoral ligament (MPFL) reconstruction for lateral patellofemoral instability altered the patellar height ratio. Secondary purposes were to use disease\u2010specific quality\u2010of\u2010life scores to determine if MPFL reconstruction is as successful in patients with patella alta, compared to those without; and whether the change in the patellar height ratio after MPFL reconstruction is influenced by demographic and clinical factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Demographic and clinical data were collected pre\u2010operatively on 283 patients with recurrent patellofemoral instability. Pre\u2010operative and 6\u2010month post\u2010operative true\u2010lateral radiographs were assessed to determine the patellar height ratio using the Caton\u2010Deschamps index. A Caton\u2010Deschamps index\u2009\u2265\u20091.2 was defined as patella alta. Paired <jats:italic>t<\/jats:italic> tests evaluated the effect of MPFL reconstruction on the Caton\u2010Deschamps index. Using a two\u2010sample <jats:italic>t<\/jats:italic> test, pre\u2010 and 24\u2010month post\u2010operative Banff Patellofemoral Instability Instrument (BPII) scores were assessed for differences in clinical outcomes between patients with and without patella alta. Pearson (for continuous variables) and Spearman rank correlations (for binary\/ordinal variables) were calculated to determine the relationship between the patellar height ratio, demographic and pathoanatomic risk factors, and pre\u2010 and post\u2010operative BPII scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pre\u2010 and post\u2010operative true\u2010lateral radiographs were admissible for 229\/283 patients (81%) following isolated MPFL reconstruction. A statistically significant difference in the Caton\u2010Deschamps index was evident from pre\u2010 to post\u2010operative for the entire cohort (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The mean decrease in ratio was 0.03, and the effect size was 0.27, classified as small. Pre\u2010operatively 52\/229 patients (22.7%) demonstrated a Caton\u2010Deschamps index\u2009\u2265\u20091.2, mean\u2009=\u20091.27 (SD\u2009=\u20090.08); post\u2010operatively 21\/229 patients (9.2%) demonstrated patella alta, mean\u2009=\u20091.18, (SD\u2009=\u20090.10), <jats:italic>p\u2009<\/jats:italic>&lt;\u20090.001 (two\u2010tailed). The mean decrease in the Caton\u2010Deschamps index for patients with pre\u2010operative patella alta was 0.10; the effect size was 0.82, classified as large. Pearson <jats:italic>r<\/jats:italic> correlation of patella alta to the pre\u2010 and post\u2010operative BPII scores demonstrated no statistically significant relationship.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study has demonstrated that treatment of lateral patellofemoral instability with an isolated MPFL reconstruction results in a statistically significant decrease in patellar height ratio, with the effect size being greatest in patients with higher pre\u2010operative Caton\u2010Deschamps indices. In patients that presented with patella alta, normalization of the patellar height ratio occurred in 31\/52 (59.6%) of the cases. Pre\u2010operative patella alta was not associated with a statistically significant difference in disease\u2010specific BPII outcome scores at any time point. Given these findings, the utility and results of tibial tubercle distalization in patients with patella alta should be a focus of further research.<\/jats:p><jats:p>Level of evidence<\/jats:p><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-020-05977-8","type":"journal-article","created":{"date-parts":[[2020,4,9]],"date-time":"2020-04-09T12:03:43Z","timestamp":1586433823000},"page":"546-552","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Patella alta is reduced following MPFL reconstruction but has no effect on quality\u2010of\u2010life outcomes in patients with patellofemoral instability"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7795-9565","authenticated-orcid":false,"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":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3837-2091","authenticated-orcid":false,"given":"Mark R.","family":"Lafave","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Health and Physical Education Mount Royal University Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Tucker","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Nova Scotia Health Authority Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,9]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010011\u20101236\u20104"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510373887"},{"key":"e_1_2_10_4_2","first-page":"290","article-title":"Patella alta: a comprehensive review of current knowledge","volume":"46","author":"Biedert RM","year":"2017","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"e_1_2_10_5_2","first-page":"317","article-title":"Patella infera. 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