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The present study aimed to retrospectively analyze the preoperative magnetic resonance imaging (MRI)\u2010based parameters of patients treated with medial reefing and whether these parameters lead to a higher risk of recurrent dislocation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010five patients (18.6\u2009\u00b1\u20096.6 years) who underwent medial reefing after primary traumatic patellar dislocation (84% with medial patellofemoral ligament [MPFL] rupture) were included. Patients were followed up for at least 24\u00a0months postoperatively (3.8\u2009\u00b1\u20091.2 years) to assess the incidence of recurrent patellar dislocation. In patients without recurrent dislocation, the Kujala and subjective IKDC scores were assessed. Moreover, the tibial tubercle\u2010trochlear groove (TT\u2010TG), sulcus angle, patellar tilt, patellar shift, and lateral trochlea index (LTI) were measured. The patellar height was measured using the Caton\u2010Dechamps (CDI), Blackburne\u2010Peel (BPI), and Insall\u2010Salvati index (ISI). The cohort was subclassified into two groups with and without recurrent dislocation. Differences between groups were analyzed with respect to the MRI parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty percent had a pathological sulcus angle of\u2009&gt;\u2009145\u00b0, 7.2% had an LTI of\u2009&lt;\u200911\u00b0, 47.3% had a patellar tilt of\u2009&gt;\u200920\u00b0, and 36.4% had a TT\u2010TG of\u2009\u2265\u200916\u00a0mm. Increased patellar height was observed in 34.5, 65.5, and 34.5% of the patients as per CDI, BPI, and ISI, respectively. Nineteen (34.5%) patients suffered from recurrent dislocation. Compared with patients without recurrent dislocation, those with recurrent dislocation had a significantly lower LTI (<jats:italic>p<\/jats:italic>\u2009=\u20090.0467). All other parameters were not significantly different between the groups. Risk factor analysis showed higher odds ratios (OR\u2009&gt;\u20092), although not statistically significant, for MPFL rupture (OR 2.05 [95% confidence interval 0.38\u201311.03], LTI (6.6 [0.6\u201368.1]), TT\u2010TG (2.9 [0.9\u20139.2]), and patellar height according to ISI (2.3 [0.7\u20137.5]) and CDI (2.3 [0.7\u20137.5])). Patients without recurrent dislocation had a Kujala score of 93.7\u2009\u00b1\u200912.1 (42\u2013100) points and an IKDC score of 90.6\u2009\u00b1\u200911.7 (55.2\u2013100) points.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Anatomical, MRI\u2010based parameters should be considered before indicating medial reefing. A ruptured MPFL, an LTI\u2009&lt;\u200911\u00b0, a TT\u2010TG\u2009\u2265\u200916\u00a0mm, a patellar tilt\u2009&gt;\u200920\u00a0mm, and an increased patellar height according to ISI and CDI were found to be associated, although not significantly, with a higher risk (OR\u2009&gt;\u20092) of recurrent patellar dislocation after medial reefing. Thorough preoperative analysis is crucial to reduce the risk of recurrent dislocation in young patient cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level IV<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06581-0","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T03:02:21Z","timestamp":1621911741000},"page":"1404-1413","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Increased tibial tubercle\u2010trochlear groove and patellar height indicate a higher risk of recurrent patellar dislocation following medial reefing"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7044-4182","authenticated-orcid":false,"given":"Marc\u2010Daniel","family":"Ahrend","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"},{"name":"<!--<label>2<\/label>--> AO Research Institute Davos Davos Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Eisenmann","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Herbst","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyko","family":"Gueorguiev","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> AO Research Institute Davos Davos Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Keller","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Diagnostic and Interventional Radiology University Hospital Tuebingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Schmidutz","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"D\u00f6bele","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Schr\u00f6ter","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Department of Traumatology and Reconstructive Surgery Diakonie Klinikum GmbH Jung\u2010Stilling\u2010Krankenhaus Siegen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Ihle","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Traumatology and Reconstructive Surgery, BG Trauma Center T\u00fcbingen Eberhard Karls University T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,25]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518803936"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4117-y"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2650-5"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-005-0015-4"},{"key":"e_1_2_9_6_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_9_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05570-8"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.59B2.873986"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513506839"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05447-w"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.216.2.r00au07582"},{"key":"e_1_2_9_12_2","first-page":"317","article-title":"Patella infera. 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All other authors declare no potential conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the local ethics committee\u00a0of the University of T\u00fcbingen (195\/2014BO2).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was provided by all patients included into the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}