{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:47:12Z","timestamp":1793148432235,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T00:00:00Z","timestamp":1611100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T00:00:00Z","timestamp":1611100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T00:00:00Z","timestamp":1611100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/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":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Medial patellofemoral ligament reconstruction (MPFLR) is often indicated in athletes with lateral patellar instability to prevent recurrence and allow for a successful return to play. In this patient population, the ability to return to play is one of the most important clinical outcomes. The purpose of the current study was to analyze the characteristics of patients who were unable return to play following MPFL reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of patients who underwent MPFL reconstruction and subsequently did not return to play after a minimum of 12\u2010months of follow\u2010up was performed. Patients were evaluated for their psychological readiness to return to sport using the MPFL\u2010Return to Sport after Injury (MPFL\u2010RSI) score, which is a modification of the ACL\u2010RSI score. A MPFL\u2010RSI score\u2009&gt;\u200956 is considered a passing score for being psychologically ready to return to play. Additionally, reasons for not returning to play including Visual Analog Scale for pain (VAS), Kujala score, satisfaction, and recurrent instability (including dislocations and subluxations) were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included a total of 35 patients who were unable to return to play out of a total cohort of 131 patients who underwent MPFL reconstruction as treatment for patellar instability. Overall, 60% were female with a mean age of 24.5, and a mean follow\u2010up of 38\u00a0months. Nine patients (25.7%) passed the MPFL\u2010RSI benchmark of 56 with a mean overall score of 44.2\u2009\u00b1\u200921.8. The most common primary reasons for not returning to play were 14 were afraid of re\u2010injury, 9 cited other lifestyle factors, 5 did not return due to continued knee pain, 5 were not confident in their ability to perform, and 2 did not return due to a feeling of instability. The mean VAS score was 1.9\u2009\u00b1\u20092.3, the mean Kujala score was 82.5\u2009\u00b1\u200914.6, and the mean satisfaction was 76.9%. Three patients (8.7%) reported experiencing a patellar subluxation event post\u2010operatively. No patient sustained a post\u2010operative patellar dislocation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Following MPFL reconstruction, patients that do not return to play exhibit poor psychological readiness with the most common reason being fear of re\u2010injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06440-y","type":"journal-article","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T05:03:26Z","timestamp":1611119006000},"page":"3834-3838","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Patients unable to return to play following medial patellofemoral ligament reconstructions demonstrate poor psychological readiness"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7696-2981","authenticated-orcid":false,"given":"Eoghan T.","family":"Hurley","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery New York University Langone Health 333 E 38th Street New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle H.","family":"Markus","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery New York University Langone Health 333 E 38th Street New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J.","family":"Mannino","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery New York University Langone Health 333 E 38th Street New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillem","family":"Gonzalez\u2010Lomas","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery New York University Langone Health 333 E 38th Street New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Alaia","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery New York University Langone Health 333 E 38th Street New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirk A.","family":"Campbell","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery New York University Langone Health 333 E 38th Street New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laith M.","family":"Jazrawi","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery New York University Langone Health 333 E 38th Street New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Strauss","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery New York University Langone Health 333 E 38th Street New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,20]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"crossref","unstructured":"AmbraLF FrancioziCE PhanA FaloppaF GomollAHIsolated MPTL reconstruction fails to restore lateral patellar stability when compared to MPFL reconstruction.Knee Surg Sports TraumatolArthrosc(2020)10.1007\/s00167\u2010020\u201006015\u20103","DOI":"10.1007\/s00167-020-06015-3"},{"key":"e_1_2_9_3_2","unstructured":"BoelchSP GurokA GilbertF WeissenbergerM RudertM BarthelTet al. 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Five\u2010year follow\u2010up results of medial patellofemoral ligament reconstruction with soft tissue patellar fixation.IntOrthop(2021)10.1007\/s00264\u2010020\u201004922\u20101"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0000000000000252"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2015.06.030"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465980260012701"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120926178"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503260788"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports\u20102015\u2010094850"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010017\u20104645\u20100"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2019.10.015"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010200709000\u201000016"},{"issue":"3082","key":"e_1_2_9_13_2","first-page":"e3081","article-title":"Which technique is better for treating patellar dislocation? 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Good results are reported at 60\u2010month follow\u2010up after medial patello\u2010femoral ligament reconstruction with fascia lata allograft for recurrent patellar dislocation.Knee Surg Sports TraumatolArthrosc(2020)10.1007\/s00167\u2010020\u201006142\u2010x","DOI":"10.1007\/s00167-020-06142-x"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518825258"},{"key":"e_1_2_9_17_2","first-page":"1815","article-title":"Surgical management for recurrent patellar dislocations in skeletally immature patients","volume":"29","author":"Migliorini F","year":"2019","journal-title":"Eur J OrthopSurgTraumatol"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519887952"},{"key":"e_1_2_9_19_2","first-page":"2277","article-title":"Surgical versus conservative treatment of primary patellar dislocation. 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The ankle ligament reconstruction\u2010return to sport after injury (ALR\u2010RSI) is a valid and reproducible scale to quantify psychological readiness before returning to sport after ankle ligament reconstruction.Knee Surg Sports TraumatolArthrosc(2020)10.1007\/s00167\u2010020\u201006020\u20106","DOI":"10.1007\/s00167-020-06020-6"},{"key":"e_1_2_9_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178\u2010018\u20109479\u2010y"},{"key":"e_1_2_9_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010019\u20102689\u20107"},{"key":"e_1_2_9_29_2","unstructured":"UimonenMM RepoJP HuttunenTT NurmiH MattilaVM PalonevaJSurgery for patellar dislocation has evolved towards anatomical reconstructions with assessment and treatment of anatomical risk factors.Knee Surg Sports TraumatolArthrosc(2020)10.1007\/s00167\u2010020\u201006277\u2010x"},{"key":"e_1_2_9_30_2","first-page":"9","article-title":"Development and preliminary validation of a scale to measure the psychological impact of returning to sport following anterior cruciate ligament reconstruction surgery","volume":"9","author":"Webster KE","year":"2008","journal-title":"PhysTher Sport"},{"key":"e_1_2_9_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517713663"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-021-06440-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00167-021-06440-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-021-06440-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-021-06440-y","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T12:32:51Z","timestamp":1760877171000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-021-06440-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,20]]},"references-count":30,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1007\/s00167-021-06440-y"],"URL":"https:\/\/doi.org\/10.1007\/s00167-021-06440-y","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,20]]},"assertion":[{"value":"17 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Each author certifies that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent\/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval was received by NYU Langone Institutional Review Board (#20-00972).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"A waiver of documentation of Informed Consent was granted in accordance with 45 CFR 46.117 (c) (2).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}