{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T05:39:33Z","timestamp":1789882773273,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,4,16]],"date-time":"2023-04-16T00:00:00Z","timestamp":1681603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,4,16]],"date-time":"2023-04-16T00:00:00Z","timestamp":1681603200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,4,16]],"date-time":"2023-04-16T00:00:00Z","timestamp":1681603200000},"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>Understanding how surgical procedures influence anatomic factors associated with patellofemoral instability can help guide surgeons when planning treatments for individual patients. This study sought to understand how patellar tilt is affected in adolescent patients with elevated pre\u2010operative tibial tuberosity to trochlear groove (TT\u2010TG) values undergoing medial patellofemoral ligament reconstruction (MPFLR) with or without an anterior medializing osteotomy (AMZ).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Utilizing a prospective database of 274 patellofemoral instability patients who underwent MPFLR\u2009\u00b1\u2009AMZ by one of two orthopedic surgeons at a single institution, those who underwent MPFLR\u2009+\u2009AMZ were identified. Pre\u2010operative and post\u2010operative magnetic resonance imaging (MRI) were used to measure TT\u2010TG distance, while radiographs were used to measure patellar tilt (tilt). Patients were matched based on age at surgery (within 2 years) and pre\u2010operative TT\u2013TG distance (within 2\u00a0mm) to a comparison cohort of patients who underwent isolated MPFLR (iMPFLR) without osseous procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 56 patients were analyzed (28 per group). The mean age of the cohort was 15.5\u2009\u00b1\u20092.0 years and was similar between both groups (15.9\u2009\u00b1\u20091.9 versus 15.1\u2009\u00b1\u20092.0 years [n.s]). When comparing the two cohorts, significant pre\u2010 to post\u2010operative decreases in patellar tilt for both MPFLR\u2009+\u2009AMZ (6.6 degrees, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and iMPFLR (3.9 degrees, p\u2009=\u20090.013) were noted. While there were no differences in pre\u2010operative patellar tilt (21.2\u2009\u00b1\u20093.5 versus 21.1\u2009\u00b1\u20093.4 [n.s]), post\u2010operatively, MPFLR\u2009+\u2009AMZ had significantly less patellar tilt than iMPFLR (13.2\u2009\u00b1\u20095.5 versus 16.5\u2009\u00b1\u20094.4, <jats:italic>p<\/jats:italic>\u2009=\u20090.017).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study found that patellar tilt significantly improved in participants undergoing either MPFLR\u2009+\u2009AMZ or iMPFLR. In addition, those undergoing MPFLR\u2009+\u2009AMZ were found to have significantly lower post\u2010operative tilt than those undergoing iMPFLR. If patellar tilt is found pre\u2010operatively to be significantly elevated and a risk for future dislocations, these findings suggest that surgeons might strongly consider MPFLR with AMZ to further address the increased tilt.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-023-07396-x","type":"journal-article","created":{"date-parts":[[2023,4,16]],"date-time":"2023-04-16T07:02:02Z","timestamp":1681628522000},"page":"3399-3404","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Concomitant anterior medializing osteotomy and MPFL reconstruction improves patellar tilt when compared to MPFL reconstruction alone"],"prefix":"10.1002","volume":"31","author":[{"given":"Nicolas","family":"Pascual\u2010Leone","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Pediatric Orthopaedic Surgery Hospital for Special Surgery New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle E.","family":"Chipman","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Pediatric Orthopaedic Surgery Hospital for Special Surgery New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blake C.","family":"Meza","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Pediatric Orthopaedic Surgery Hospital for Special Surgery New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas N.","family":"Mintz","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Radiology &amp; Imaging Hospital for Special Surgery New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"Fabricant","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Pediatric Orthopaedic Surgery Hospital for Special Surgery New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7286-6864","authenticated-orcid":false,"given":"Daniel W.","family":"Green","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Pediatric Orthopaedic Surgery Hospital for Special Surgery New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,16]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/18632521221149055"},{"key":"e_1_2_10_3_2","unstructured":"AckermannJ HaslerJ GrafDN FucenteseSF VlachopoulosLThe effect of native knee rotation on the tibial\u2010tubercle\u2010trochlear\u2010groove distance in patients with patellar instability: an analysis of MRI and CT measurements.Arch Orthop Trauma 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November 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 March 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 April 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"NPL, DEC, BCM, and DNM have no conflicts of interest to disclose. PDF is a consultant for Osso VR, a consultant for WishBone Orthopedics, and associate editor for Clinical Orthopedics and Related Research (CORR). DWG is a consultant for Arthrex Inc. and receives royalties for Arthrex Inc. and Pega Medical.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was reviewed and approved by the Hospital for Special Surgery Institutional Review Board.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not required for this study, as it was retrospective.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}