{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T18:51:22Z","timestamp":1793472682439,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T00:00:00Z","timestamp":1546560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T00:00:00Z","timestamp":1546560000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T00:00:00Z","timestamp":1546560000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T00:00:00Z","timestamp":1546560000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/100011549","name":"American Orthopaedic Society for Sports Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011549","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008187","name":"Histogenics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008187","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008894","name":"Stryker","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008894","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008894","name":"Stryker","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008894","id-type":"DOI","asserted-by":"crossref"}]},{"name":"American Journal of Sports Medicine,"},{"DOI":"10.13039\/100011549","name":"American Orthopaedic Society for Sports Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011549","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NBA\/GE Strategic Advisory Board"},{"name":"Tenex Health"},{"name":"Ceterix"},{"DOI":"10.13039\/100008187","name":"Histogenics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008187","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To describe the clinical history of a series of primary, lateral patellar dislocations and determine long\u2010term predictors of recurrent instability while accounting for patients undergoing early operative management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A\u00a0large geographic database of more than 500,000 patients was used to identify patients who sustained a first\u2010time lateral patellar dislocation between 1990 and 2010. Charts were individually reviewed to document demographics, radiographic measures including tibial tubercle to trochlear groove distance (TT\u2010TG) and patellar length (PL), recurrent episodes of instability, and patellar stabilization surgery. A risk score that accounted for early surgical management was calculated using Fine and Gray competing risk regression, and its ability to stratify patients was examined using cumulative incidence curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty\u2010one patients (mean age 19.9 \u00b1 9.4\u00a0years, 38 male, 43 female) were identified and followed for a mean of 10.1\u00a0years (range 4.1\u201020.2). Thirty\u2010eight patients (46.9%) experienced an episode of recurrent instability and 30 (37.0%) underwent patellar stabilization surgery, including 7 who did so before recurrent dislocation. A\u00a0multivariate, statistically derived scoring system, the Recurrent Instability of the Patella Score (RIP Score), that employed age, skeletal maturity, trochlear dysplasia, and TT\u2010TG\/PL ratio to predict recurrent instability while accounting for patients managed surgically, was generated. The resulting RIP score stratified patients into low\u2010, intermediate\u2010, and high\u2010risk categories, with 0.0%, 30.6%, and 79.2% 10\u2010year recurrent instability rates, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .000004), and an area under the curve of 0.875 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .00002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients who sustain a first\u2010time, lateral patellar dislocation can be readily classified into low\u2010, intermediate\u2010, and high\u2010risk categories employing the RIP score based on age, skeletal maturity, trochlear dysplasia, and TT\u2010TG\/PL ratio. This long\u2010term risk stratification holds significant potential clinical utility for determination of patients who are at high risk for recurrent instability after primary patellar dislocation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level\u00a0of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2018.09.017","type":"journal-article","created":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T01:26:20Z","timestamp":1546565180000},"page":"537-543","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":124,"title":["The Recurrent Instability of the Patella Score: A Statistically Based Model for Prediction of Long\u2010Term Recurrence Risk After First\u2010Time Dislocation"],"prefix":"10.1002","volume":"35","author":[{"given":"Mario","family":"Hevesi","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Mayo Clinic Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Heidenreich","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Mayo Clinic Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher L.","family":"Camp","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Mayo Clinic Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy E.","family":"Hewett","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Mayo Clinic Rochester Minnesota U.S.A."},{"name":"Department of Physiology &amp; Biomedical Engineering Mayo Clinic Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Stuart","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Mayo Clinic Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane L.","family":"Dahm","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Mayo Clinic Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron J.","family":"Krych","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Mayo Clinic Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,4]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4752-y"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000674"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01552649"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465980260012701"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197210000-00012"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2014.12.001"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.4103\/ortho.IJOrtho_164_17"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503260788"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-5919(02)00031-5"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465000280040601"},{"key":"e_1_2_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517704178"},{"key":"e_1_2_2_13_2","article-title":"Incidence of first\u2010time lateral patellar dislocation: A 21\u2010year population\u2010based study","author":"Sanders T.L.","year":"2017","journal-title":"Sports Health."},{"key":"e_1_2_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510371423"},{"key":"e_1_2_2_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465980260012501"},{"key":"e_1_2_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.09.025"},{"key":"e_1_2_2_17_2","doi-asserted-by":"crossref","unstructured":"Liu JN Steinhaus ME Kalbian IL et\u00a0al. 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