{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:57:26Z","timestamp":1785545846309,"version":"3.56.0"},"reference-count":38,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,5,19]],"date-time":"2018-05-19T00:00:00Z","timestamp":1526688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,5,19]],"date-time":"2018-05-19T00:00:00Z","timestamp":1526688000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2018,5,19]],"date-time":"2018-05-19T00:00:00Z","timestamp":1526688000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","arthroscopyjournal.org","clinicalkey.fr","clinicalkey.com.au","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To analyze the relation of the femoral tunnel (FT) positioning on clinical outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with recurrent patellar dislocation who underwent medial patellofemoral ligament (MPFL) reconstruction with or without tibial tubercle osteotomy between 1998 and 2012 were included in this retrospective study. Strict postoperative lateral radiographs were mandatory. Knees with previous osseous stabilization surgery, fixed lateral patellar dislocation, valgus knee (&gt;5\u00b0), or open growth plates were excluded. The distance between the FT and the validated radiographic landmark (the \u201cSchoettle point\u201d) was measured. An FT with a distance greater than 10\u00a0mm was considered as malpositioned. The distance was correlated to subjective outcome measurements (patient satisfaction and Kujala score) and postoperative complications (a loss of range of motion and revision surgery).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010three knees in 60 patients (aged 23.7 \u00b1 7.5\u00a0years at the time of surgery, 79.4% female) were included with a mean follow\u2010up of 5.7 \u00b1 3.3\u00a0years. The FT showed an average distance of 13.3\u00a0mm (\u00b16.0\u00a0mm; 95% confidence interval [CI]: 11.7\u201014.8) to the Schoettle point, and 45 of 63 knees (71.4%) were deemed malpositioned. The postoperative Kujala score of malpositioned FT (75.9 points; 95% CI: 71.2\u201080.7) was not significantly inferior to knees with an FT within 10\u00a0mm (80.5; 95% CI: 73.7\u201087.3,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .315). However, all 5 knees that underwent revision surgery showed an FT outside the 10\u2010mm area.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Malpositioning of the FT in MPFL reconstruction is associated with postoperative complications. However, a malpositioned FT in MPFL reconstruction will not necessarily lead to an unsatisfactory subjective or objective clinical outcome. Other factors, such as\u00a0surgical indication or graft tensioning, might also significantly influence postoperative outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, case\u2010control study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2018.02.046","type":"journal-article","created":{"date-parts":[[2018,5,19]],"date-time":"2018-05-19T07:52:40Z","timestamp":1526716360000},"page":"2410-2416","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":50,"title":["The Relationship of Femoral Tunnel Positioning in Medial Patellofemoral Ligament Reconstruction on Clinical Outcome and Postoperative Complications"],"prefix":"10.1002","volume":"34","author":[{"given":"Philippe M.","family":"Tscholl","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Balgrist University Hospital University of Zurich Zurich Switzerland"},{"name":"Department of Orthopaedic Surgery and Traumatology University Hospitals of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Ernstbrunner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Balgrist University Hospital University of Zurich Zurich Switzerland"},{"name":"Department of Orthopedics and Traumatology Paracelsus Medical University Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Pedrazzoli","sequence":"additional","affiliation":[{"name":"Medical School University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro F.","family":"Fucentese","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Balgrist University Hospital University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,19]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507299237"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-0160(03)00006-1"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2011.08.001"},{"key":"e_1_2_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2014.09.023"},{"key":"e_1_2_3_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.O.00354"},{"key":"e_1_2_3_7_2","first-page":"37","article-title":"Recurrent patellar instability\u2014An update of current literature","volume":"67","author":"Tscholl P.M.","year":"2016","journal-title":"Minerva Ortop E Traumatol"},{"key":"e_1_2_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512442330"},{"key":"e_1_2_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967115569198"},{"key":"e_1_2_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-010-1235-9"},{"key":"e_1_2_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506287486"},{"key":"e_1_2_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513509230"},{"key":"e_1_2_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-011-1871-8"},{"key":"e_1_2_3_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506296415"},{"key":"e_1_2_3_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510381362"},{"key":"e_1_2_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2797-0"},{"key":"e_1_2_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-004-0607-4"},{"key":"e_1_2_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-0160(03)00038-3"},{"key":"e_1_2_3_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-015-3905-0"},{"key":"e_1_2_3_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967116687749"},{"key":"e_1_2_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2015.11.021"},{"key":"e_1_2_3_22_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00909"},{"key":"e_1_2_3_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-005-0659-0"},{"key":"e_1_2_3_24_2","first-page":"1466","article-title":"Douleurs et instabilit\u00e9 rotulienne. 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