{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:41:20Z","timestamp":1790419280380,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"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":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Medial patellofemoral ligament reconstruction (MPFL\u2010R) is a recognised surgical procedure for the treatment of recurrent patellofemoral instability with excellent outcomes reported. The aim of this study is to determine if body mass index can influence these outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single\u2010centre retrospective analysis of a longitudinal patellofemoral database. Patients with recurrent patellar instability, without patellar alta or severe trochlear dysplasia were treated using a MPFL\u2010R between 2015 and 2019 at The Robert Jones &amp; Agnes Hunt Orthopaedic Hospital. The clinical efficacy following surgery was assessed by Kujula, International Knee Documentation Committee Score (IKDC), and EuroQol\u20105 score (EQ\u20105D) at baseline and up to 26\u00a0months post\u2010operatively; their safety assessed by complication rate and requirement for further surgery. The effect of Body Mass Index (BMI) on clinical outcome was analysed using linear, curvilinear, and segmented models following propensity score weighting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 97 patients (97\u00a0Knees, mean age 25y) were analysed. Of these, 61 patients had a BMI\u2009&lt;\u200930\u00a0kg\/m<jats:sup>2<\/jats:sup> (mean age 23y, mean BMI 24) of which 7 patients (12.3%) required additional surgery. A further 36 patients had a BMI\u2009&gt;\u200930\u00a0kg\/m<jats:sup>2<\/jats:sup> (mean age 27y, mean BMI 36) of which 2 patients (5.6%) required additional surgery. The re\u2010dislocation rate was 0% in each BMI group. Both groups had a significantly improved mean outcome following surgery, with improvements in mean IKDC above the minimum clinical important differences (MCID) of 20.5. BMI had an inverted J\u2010shaped association with functional outcome, showing peak outcomes at BMI of 20.5 (95% CI 18.5 to 22.4; IKDC and Kujala) or BMI of 28 (EQ\u20105D index). No evidence for an association between BMI and complication risk was found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BMI influences the functional outcomes in MPFL\u2010R with an inverted J\u2010shaped relation, without evidence it affected the complication or re\u2010dislocation rate. In the absence of patella alta and severe trochlear dysplasia, an isolated MPFL reconstruction is a safe and effective procedure to treat patellar instability, with the best functional outcome in patients with a BMI around 20 to 21.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-023-07391-2","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T10:02:56Z","timestamp":1681120976000},"page":"3381-3389","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Functional outcomes after Medial Patellofemoral Ligament Reconstruction show inverted J\u2010shaped relation with Body Mass Index"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8918-9871","authenticated-orcid":false,"given":"N.","family":"Sharma","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Robert Jones and Agnes Hunt Orthopaedic Hospital Gobowen SY10 7AG Oswestry UK"},{"name":"<!--<label>2<\/label>--> 28 Buckingham Road, Penn WV4\u20105TJ Wolverhampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Al\u2010Mouazzen","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Robert Jones and Agnes Hunt Orthopaedic Hospital Gobowen SY10 7AG Oswestry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. H.","family":"Kuiper","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Robert Jones and Agnes Hunt Orthopaedic Hospital Gobowen SY10 7AG Oswestry UK"},{"name":"<!--<label>3<\/label>--> Keele University Stoke\u2010on\u2010Trent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Gallacher","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Robert Jones and Agnes Hunt Orthopaedic Hospital Gobowen SY10 7AG Oswestry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Barnett","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Robert Jones and Agnes Hunt Orthopaedic Hospital Gobowen SY10 7AG Oswestry 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