{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:40:33Z","timestamp":1793724033568,"version":"4.6.1"},"reference-count":0,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/100007307","name":"Arthrex","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007307","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007307","name":"Arthrex","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007307","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medshape and Orthoregenerative Technologies"}],"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":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Tibial tubercle osteotomy (TTO) is a procedure that may be used to address a wide array of patellofemoral joint pathology. The most common indications for TTO include (1) patellar instability, including either a lateralized force vector or abnormal patellar alta, and (2) patellar focal cartilage defects or chondromalacia. Customization of the TTO can effectively address the patellofemoral joint pathology by modifying patellar tracking in the trochlear groove and\/or altering the contact pressures experienced by the patellofemoral cartilage. TTO may be most successful when performed in conjunction with soft\u2010tissue stabilization and\/or biological augmentation of chondral injuries. Specifically, isolated anteromedialization is recommended for focal, distal lateral patellar lesions; combined anteromedialization and cartilage restoration are recommended for medial, central, and\/or panpatellar cartilage pathology; medialization with soft\u2010tissue stabilization is recommended for a lateralized tubercle position (elevated tibial tubercle\u2013trochlear groove distance); and distalization with soft\u2010tissue stabilization is recommended for patella alta. Clinical studies have shown good to excellent results at long\u2010term follow\u2010up when a TTO is performed for patellar instability, whereas TTO performed for chondral defects has shown good to excellent outcomes that correlate strongly with the size and location of the chondral defect. With appropriate patient selection, TTO is a valuable tool for the treatment of patellofemoral joint pathology.<\/jats:p>","DOI":"10.1016\/j.arthro.2019.05.013","type":"journal-article","created":{"date-parts":[[2019,8,5]],"date-time":"2019-08-05T18:11:45Z","timestamp":1565028705000},"page":"2255-2256","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":28,"title":["Optimizing Patellofemoral Cartilage Restoration and Instability With Tibial Tubercle Osteotomy"],"prefix":"10.1002","volume":"35","author":[{"given":"Seth L.","family":"Sherman","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery University of Missouri Columbia Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Humpherys","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Missouri Columbia Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Farr","sequence":"additional","affiliation":[{"name":"Cartilage Restoration Center, OrthoIndy Greenwood Indiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,1]]},"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806319304281?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806319304281?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2019.05.013","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2019.05.013","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2019.05.013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T08:56:08Z","timestamp":1773564968000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2019.05.013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":0,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1016\/j.arthro.2019.05.013"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2019.05.013","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Optimizing Patellofemoral Cartilage Restoration and Instability With Tibial Tubercle Osteotomy","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2019.05.013","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 by the Arthroscopy Association of North America","name":"copyright","label":"Copyright"}]}}