{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:28:38Z","timestamp":1790206118004,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T00:00:00Z","timestamp":1671840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T00:00:00Z","timestamp":1671840000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T00:00:00Z","timestamp":1671840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Isolated MPFL reconstruction (iMPFLR) is increasingly used for the surgical treatment of treatment for recurrent patella dislocation. The purpose of this study was to evaluate the influence of tunnel widening and migration on clinical outcomes after iMPFL using a CT\u2010scannographic analysis at 6\u00a0months postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred and sixty patients (91 females for 69\u00a0males) with an average age of 23 years [14\u201354] who underwent iMPFLR and had an evaluation scan at 6\u00a0months postoperatively were evaluated with a mean follow\u2010up of 97\u2009\u00b1\u200989\u00a0months [12 to 166]. Functional International Knee Documentation Committee (IKDC) Score, Kujala score, and joint mobility were assessed preoperatively, at 6\u00a0months and at the latest follow\u2010up. The IKDC and Kujala scores were expressed as the difference between pre\u2010 and postoperative scores (dIKDC and dKujala). The position of the femoral tunnel was assessed according to the Sch\u00f6ttle criteria on post\u2010operative radiographic profiles. Tunnel widening (at three levels of measurement) and the migration of the center of the tunnel were studied on a CT\u2010scan analysis at 6\u00a0months. Any correlation and regression between the evolution of the clinical scores and the measured scannographic parameters were investigated. The relationships between tunnel position and tunnel changes were also studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between pre\u2010 and post\u2010op, the IKDC (45\u2009\u00b1\u200913 to 80\u2009\u00b1\u200915, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and Kujala (55\u2009\u00b1\u200911 to 87\u2009\u00b1\u200912, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) scores were significantly improved. Patients with tunnel changes had decreased clinical and functional results at 6\u00a0months post\u2010op of an iMPFLR (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). These changes in the femoral tunnel, evidenced by a tunnel entrance widening and migration of the tunnel center, were related to an initial malposition of the tunnel (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In iMPFLR, changes in the femoral tunnel, corresponding to dilatation and migration of the tunnel center, may occur. These changes are increased by the initial malpositioning of the femoral tunnel and are correlated with less good clinical and functional outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07277-9","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T23:22:16Z","timestamp":1671837736000},"page":"2315-2322","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["After MPFL reconstruction, femoral tunnel widening and migration increase with poor tunnel positioning and are related to poor clinical outcomes"],"prefix":"10.1002","volume":"31","author":[{"given":"Fabien","family":"Ewald","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery University Hospital of Saint \u00c9tienne CEDEX 2 42055 Saint \u00c9tienne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Klasan","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Johannes Kepler University Linz Linz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Putnis","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> University Hospitals Bristol and Weston NHS Foundation Trust Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Farizon","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery University Hospital of Saint \u00c9tienne CEDEX 2 42055 Saint \u00c9tienne France"},{"name":"<!--<label>2<\/label>--> EA 7424\u2010Interuniversity Laboratory of Human Movement Science University Lyon\u2010University Jean Monnet Saint \u00c9tienne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00e9mi","family":"Philippot","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery University Hospital of Saint \u00c9tienne CEDEX 2 42055 Saint \u00c9tienne France"},{"name":"<!--<label>2<\/label>--> EA 7424\u2010Interuniversity Laboratory of Human Movement Science University Lyon\u2010University Jean Monnet Saint \u00c9tienne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Neri","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery University Hospital of Saint \u00c9tienne CEDEX 2 42055 Saint \u00c9tienne France"},{"name":"<!--<label>2<\/label>--> EA 7424\u2010Interuniversity Laboratory of Human Movement Science University Lyon\u2010University Jean Monnet Saint \u00c9tienne France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,24]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.21037\/atm\u201019\u20103925"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010016\u20104272\u20101"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010018\u20105098\u20109"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513512771"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.08.039"},{"key":"e_1_2_10_7_2","first-page":"128","article-title":"MPFL reconstruction: indications and results","volume":"91","author":"Dall\u2019Oca C","year":"2020","journal-title":"Acta 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No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study has been approved by an ethics committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent of each patient was collected at each inclusion.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}