{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:20:36Z","timestamp":1788351636479,"version":"build-2803163510"},"reference-count":50,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,12,4]],"date-time":"2022-12-04T00:00:00Z","timestamp":1670112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,12,4]],"date-time":"2022-12-04T00:00:00Z","timestamp":1670112000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,12,4]],"date-time":"2022-12-04T00:00:00Z","timestamp":1670112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"Research Program of Shanghai Jiao Tong University Affiliated Sixth People's Hospital","award":["YNTS202001"],"award-info":[{"award-number":["YNTS202001"]}]},{"DOI":"10.13039\/100020732","name":"Innovative research team of high-level local universities in Shanghai","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100020732","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To characterize patellofemoral morphology, determine radiological cutoff values based on computed tomography (CT) images, and clarify predominant anatomic risk factors in young patients with recurrent patellar dislocation (RPD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 212\u00a0knees (age 23.0\u2009\u00b1\u20095.3 years, female: male\u2009=\u2009110:102) with CT\u2010confirmed RPD were enrolled for analysis. The control group was matched by age and sex (2:1). Patellofemoral and trochlear morphology, patellofemoral alignment, and other parameters were assessed by CT. Standardized methods were used for measurements. Receiver operating characteristic (ROC) curves and the areas under the ROC curve (AUCs) were used to assess accuracy in diagnosing RPD. The index of union (IU) was employed to identify a cutoff value for risk. A binary logistic regression model (Forward, LR) was constructed, and standardized coefficients were calculated to compare the relative strength of different predictors. Factors included in the model were employed to calculate distributions in the studied population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The majority of measurements showed a significant difference between the RPD and control groups when comparing mean values. The AUC value was favorable for sulcus depth and significantly better than that for other trochlear morphology parameters (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). Cutoff values were 0.58 for the Wiberg index, 153.3\u00b0 for the sulcus angle, 3.6\u00a0mm for the sulcus depth, 1.94 for the trochlear width ratio, 16.2\u00b0 for the lateral trochlear inclination, 17.2\u00b0 for the patellar lateral tilt, 25.5\u00b0 for the congruence angle, 1.2 for the patellar height [Caton\u2013Deschamps index (CDI)], 6.1\u00b0 for the knee rotation, and 16.4\u00a0mm for the tibial tubercle\u2013trochlear groove (TT\u2010TG) distance. A binary logistic regression model (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200920.826, <jats:italic>P<\/jats:italic>\u2009=\u20090.008) including the Wiberg index, sulcus depth, congruence angle, patellar height (CDI), and TT\u2010TG distance was constructed for RPD (<jats:italic>P<\/jats:italic>\u2009\u2264\u20090.015), which showed excellent diagnostic performance, as indicated by an AUC of 0.989 (95% CI, 0.979 to 0.998). Sulcus depth showed the strongest relationship with RPD, followed by the congruence angle and Wiberg index, as indicated by the standardized coefficients \u2212 1.43, 1.02, and 0.97, respectively. Eighty\u2010seven percent of the RPD population had sulcus depth\u2009\u2264\u20093.6\u00a0mm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study provides a systematic reference of cutoff values based on CT data. The combination of five anatomic risk factors (sulcus depth, congruence angle, Wiberg index, TT\u2010TG distance, and CDI) may be an excellent predictor of RPD as initial risk assessment. Sulcus depth, as the most frequently observed anatomic risk factor, showed the best diagnostic performance among trochlear morphological parameters and the strongest relationship with RPD, followed by the congruence angle and Wiberg index. In clinical practice, the sulcus depth, congruence angle, Wiberg index, TT\u2010TG distance, and CDI with the proposed cutoff values can be used in combination to evaluate RPD. When assessing trochlear morphology, sulcus depth is recommended as the best radiological parameter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07245-3","type":"journal-article","created":{"date-parts":[[2022,12,4]],"date-time":"2022-12-04T06:02:27Z","timestamp":1670133747000},"page":"2906-2916","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Sulcus depth, congruence angle, Wiberg index, TT\u2010TG distance, and CDI are strong predictors of recurrent patellar dislocation"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2778-4418","authenticated-orcid":false,"given":"Jiebo","family":"Chen","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sports Medicine Shanghai Sixth People\u2019s Hospital Affiliated to Shanghai Jiao Tong University 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