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reconstruction, as well as to assess for radiologic risk factors for worse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review identified all patients with lateral patellar instability who underwent either MPFL repair and\/or imbrication or MPFL reconstruction without any additional osseous procedures between 2008 and 2015 at a single center. Demographic variables and preoperative magnetic resonance imaging were analyzed, and Kujala scores were obtained at a minimum 2\u2010year follow\u2010up. Risk factors for worse outcomes were assessed, including the Caton\u2010Deschamps Index (CDI) Insall\u2010Salvati Index, tibial tubercle\u2013trochlear groove distance, and tibial tubercle\u2013posterior cruciate ligament distance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 51 knees with isolated MPFL surgery (reconstruction in 32 and\u00a0imbrication and\/or repair in 19) at a mean of 59.7\u00a0months' follow\u2010up (range, 24\u2010121\u00a0months). The overall rate of recurrent dislocations was significantly greater in the repair group (36.9%) versus the reconstruction group (6.3%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.01), despite the average CDI being significantly higher in the reconstruction group (1.34 vs 1.23 in repair group,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.04). No significant difference in the rate of return to baseline activity was found between the groups (77.8% in reconstruction group vs 70% in repair group,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .62). The average Kujala score showed no significant difference between the repair and reconstruction groups (84.15 \u00b1 14.2 vs 84.83 \u00b1 14.38,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .72). No imaging measurements were found to be predictive of a worse postoperative Kujala score; however, the average CDI among the MPFL repair failures (1.30 \u00b1 0.05) was significantly higher than among the MPFL repair nonfailures (1.18 \u00b1 0.12,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MPFL reconstruction may provide improved midterm clinical outcomes and a decreased recurrence rate compared with MPFL repair. Increased patellar height as measured by the CDI may be a risk factor for recurrent patellar instability in patients who undergo isolated MPFL repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2019.05.007","type":"journal-article","created":{"date-parts":[[2019,10,8]],"date-time":"2019-10-08T10:23:28Z","timestamp":1570530208000},"page":"2909-2915","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":62,"title":["Primary Medial Patellofemoral Ligament Repair Versus Reconstruction: Rates and Risk Factors for Instability Recurrence in a Young, Active Patient Population"],"prefix":"10.1002","volume":"35","author":[{"given":"Richard 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