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Patient\u2010reported outcome measures were recorded for knee\u2010specific function (KOOS), general quality of life (EQ\u20105D), and activity level (Tegner scale). Post\u2010operative revision interventions were also actively recorded. As potential predicting factors, patient demographic (gender, age, BMI) and radiographic (pre\u2010operative: patellar height and tilt, tibial tuberosity\u2013trochlear groove distance, trochlear dysplasia, knee osteoarthritis; post\u2010operative: MPFL insertion point; intra\u2010operative: isolated vs. combined procedures, chondropenia severity score) parameters were analyzed using multivariate linear regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>With median follow\u2010up of 4.4 (1.0\u20138.9) years, all patient\u2010reported outcome measures had significantly improved from pre\u2010operative levels: KOOS cumulative, from 71 (15) to 78 (16); EQ\u20105D, from 0.68 (0.20) to 0.78 (0.21); and Tegner activity scale, from 3 (0\u201310) to 4 (0\u201310). No patellofemoral instability revision procedures were performed. One\u2010fifth (27\/138) of the operated knees required second surgical interventions, predominately due to hardware or arthrofibrosis. Patients who required post\u2010operative knee manipulation under anesthesia or arthroscopic debridement showed lower post\u2010operative improvement for KOOS cumulative and EQ\u20105D. Age, BMI, patellofemoral knee osteoarthritis, and shorter follow\u2010up time revealed significant negative correlations to some of the post\u2010operative KOOS subscales. Age was negatively correlated to post\u2010operative EQ\u20105D, while post\u2010operative Tegner activity scale was negatively correlated to female gender and patellofemoral chondropenia severity score. Femoral MPFL insertion point revealed no association with any outcome measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patellofemoral instability surgery for isolated or combined MPFLrec is safe and substantially improves knee function and patient quality of life and activity levels. Serious adverse events are rare, with no recurrent patellofemoral instability. Patients who required post\u2010operative knee manipulation or arthroscopic debridement showed less improvement in subjective measures of treatment outcomes. Older age, higher BMI, worse pre\u2010operative patellofemoral cartilage status, and female gender had negative effects on outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-06986-5","type":"journal-article","created":{"date-parts":[[2022,5,7]],"date-time":"2022-05-07T00:19:02Z","timestamp":1651882742000},"page":"3751-3759","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Age, body mass index, female gender, and patellofemoral cartilage degeneration predict worse patient outcome after patellofemoral instability surgery"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5199-9377","authenticated-orcid":false,"given":"Nik","family":"\u017dlak","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery University Medical Centre Ljubljana Zalo\u0161ka cesta 9 1000 Ljubljana Slovenia"},{"name":"<!--<label>2<\/label>--> Chair of Orthopedics, Faculty of Medicine University of Ljubljana Ljubljana Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Kacin","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Physiotherapy, Faculty of Health Sciences University of Ljubljana Ljubljana Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Martin\u010di\u010d","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery University Medical Centre Ljubljana Zalo\u0161ka cesta 9 1000 Ljubljana Slovenia"},{"name":"<!--<label>2<\/label>--> Chair of Orthopedics, Faculty of Medicine University of Ljubljana Ljubljana Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matej","family":"Drobni\u010d","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery University Medical Centre Ljubljana Zalo\u0161ka cesta 9 1000 Ljubljana Slovenia"},{"name":"<!--<label>2<\/label>--> Chair of Orthopedics, Faculty of Medicine University of Ljubljana Ljubljana Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,7]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010016\u20104272\u20101"},{"key":"e_1_2_9_3_2","doi-asserted-by":"crossref","unstructured":"BrulcU Drobni\u010dM KolarM Stra\u017earKA prospective single\u2010center study following operative treatment for osteochondral lesions of the talus.Foot Ankle Surg(2021)10.1016\/j.fas.2021.08.00834518042","DOI":"10.1016\/j.fas.2021.08.008"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/03008207.2018.1517759"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01552649"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010014\u20103164\u20105"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2008.12.001"},{"key":"e_1_2_9_8_2","doi-asserted-by":"crossref","unstructured":"HiemstraLA KerslakeS LafaveMMedial patellofemoral ligament reconstruction femoral tunnel accuracy: relationship to disease\u2010specific quality of life.Orthop J Sport Med(2017)10.1177\/2325967116687749","DOI":"10.1177\/2325967116687749"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519841304"},{"key":"e_1_2_9_10_2","doi-asserted-by":"crossref","unstructured":"IgoumenouVG DimopoulosL MavrogenisAFPatellar height assessment methods: An update.JBJS Rev(2019)10.2106\/JBJS.RVW.18.0003830624307","DOI":"10.2106\/JBJS.RVW.18.00038"},{"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":"10.1097\/CORR.0000000000000886"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.16.4.494"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010018\u20104983\u20106"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010020\u201004747\u2010y"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010017\u20102705\u2010z"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/0963689719861922"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010013\u20102778\u20103"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590\u2010019\u201002451\u20101"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010015\u20103654\u20100"},{"issue":"2","key":"e_1_2_9_21_2","first-page":"130","article-title":"Patellar instability with recurrent dislocation due to patellofemoral dysplasia. 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