{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T15:10:04Z","timestamp":1792249804977,"version":"4.4.0"},"reference-count":44,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"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":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The primary study objective was to describe the incidence of osteochondral damage (OD) in our cohort of patients with patellar instability (PI). The secondary objective was to assess for associations between patient demographic characteristics, duration of PI, and quantitative radiographic measurements of anatomic risk factors for PI and OD in this cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective chart review identified patients treated for PI at a tertiary referral center between 2013 and 2018. Patients were evaluated for osteochondral injury with either magnetic resonance imaging if treated nonoperatively or operative reports if treated surgically. The Caton\u2010Deschamps ratio, proximal tibial tubercle\u2013to\u2013trochlear groove (pTT\u2010TG) distance, distal tibial tubercle\u2013to\u2013trochlear groove (dTT\u2010TG) distance, lateral trochlear inclination (LTI) angle, lateral patellar inclination (LPI) angle, and sulcus angle were calculated from magnetic resonance imaging scans. Trochlear dysplasia is an important risk factor for PI that can be reliability quantified by the pTT\u2010TG distance, dTT\u2010TG distance, LTI angle, sulcus angle, and LPI angle. Demographic data including age at first instability event, sex, body mass index, symptom duration, and number of dislocations were documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 125 knees in 118 patients (average age, 13.9 \u00b1 3.4 years; 48% female patients) with PI were identified. Within this cohort, 67% were treated surgically and 53% had OD. No association was identified between osteochondral injury and age, sex, body mass index, symptom duration, LTI angle, LPI angle, dTT\u2010TG distance, pTT\u2010TG distance, or number of dislocations. An increased sulcus angle (more dysplasia) showed a statistically significant association with osteochondral pathology (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .021), and higher sulcus angles were statistically significantly associated with acute osteochondral fracture compared with chondral injury (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using quantitative analysis of trochlear dysplasia, this study identified a significant association\u00a0between trochlear dysplasia (sulcus angle) and the incidence of OD in our cohort of patients with PI. The frequency of dislocation or subluxation and patient demographic characteristics were not significantly associated with OD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective prognostic study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2021.04.054","type":"journal-article","created":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T02:24:05Z","timestamp":1620181445000},"page":"3469-3476","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":23,"title":["Trochlear Dysplasia as Shown by Increased Sulcus Angle Is Associated With Osteochondral Damage in Patients With Patellar Instability"],"prefix":"10.1002","volume":"37","author":[{"given":"Lilah","family":"Fones","sequence":"first","affiliation":[{"name":"University of Connecticut School of Medicine Farmington Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew E.","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery University of Connecticut School of Medicine Farmington Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Cheng","sequence":"additional","affiliation":[{"name":"University of Connecticut School of Medicine Farmington Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Chevalier","sequence":"additional","affiliation":[{"name":"Elite Sports Medicine Connecticut Children\u2019s Medical Center Farmington Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael B.","family":"Brimacombe","sequence":"additional","affiliation":[{"name":"Department of Research Connecticut Children\u2019s Medical Center Hartford Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Cohen","sequence":"additional","affiliation":[{"name":"Elite Sports Medicine Connecticut Children\u2019s Medical Center Farmington Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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