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The pre\u2010 and postoperative J sign grade, Caton\u2010Deschamps index (CDI), tibial tuberosity\u2013trochlear groove (TT\u2013TG) distance, femoral anteversion angle (FAA), patellar lateral tilt angle (PLTA), MPFL graft laxity, and patient\u2010reported outcomes (Kujala, Lysholm, Tegner, and International Knee Documentation Committee (IKDC) subjective scores) were collected. The anterior\u2013posterior and proximal\u2013distal distances between the actual point and the Sch\u00f6ttle point were also calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen patients underwent MPFLR revision by DDFO combined with MPFLR. The mean PLTA improved from 40.7\u00b0\u2009\u00b1\u200911.9\u00b0 to 20.5\u00b0\u2009\u00b1\u20098.7\u00b0 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The mean FAA significantly decreased from 42.7\u00b0\u2009\u00b1\u200912.0\u00b0 to 14.1\u00b0\u2009\u00b1\u20095.2\u00b0 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The mean patellar laxity index (PLI) decreased from 82.4% preoperatively to 15.1% postoperatively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). None of these patients experienced subluxation or re\u2010dislocation during follow\u2010up of 29.7\u2009\u00b1\u20095.0\u00a0months after revision surgery. Meanwhile, the Tegner score at the last follow\u2010up ranged from 3 to 6, with a median of 5. The Kujala, Lysholm, and IKDC subjective scores showed significant improvements, from a mean of 51.0\u2009\u00b1\u20096.8 preoperatively to 75.4\u2009\u00b1\u20095.1 postoperatively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), 49.2\u2009\u00b1\u20097.9 to 75.2\u2009\u00b1\u20097.2 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), and 42.9\u2009\u00b1\u20096.2 to 76.8\u2009\u00b1\u20096.0 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), respectively. The proportion of patients with a high\u2010grade J sign was significantly lower postoperatively than preoperatively (100% vs. 14%). Four out of 14 patients (29%) showed femoral tunnel mal\u2010positioning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MPFLR revision by DDFO combined with MPFLR achieved favorable clinical outcomes in patients with increased femoral anteversion along with high\u2010grade J sign.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06739-w","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T09:04:36Z","timestamp":1633079076000},"page":"1809-1817","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Derotational distal femoral osteotomy yields satisfactory clinical outcomes in pathological femoral rotation with failed medial patellofemoral ligament reconstruction"],"prefix":"10.1002","volume":"30","author":[{"given":"Yanwei","family":"Cao","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Medicine, Sports Medicine Service Beijing Jishuitan Hospital No. 31, Xinjiekou East Street 10035 Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijun","family":"Zhang","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Medicine, Sports Medicine Service Beijing Jishuitan Hospital No. 31, Xinjiekou East Street 10035 Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiewei","family":"Shen","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Medicine, Sports Medicine Service Beijing Jishuitan Hospital No. 31, Xinjiekou East Street 10035 Beijing 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informed consent before participating in this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All patients provided informed consent for publication.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}