{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:12:33Z","timestamp":1789625553939,"version":"build-2803163510"},"reference-count":58,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T00:00:00Z","timestamp":1620950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T00:00:00Z","timestamp":1620950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T00:00:00Z","timestamp":1620950400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T00:00:00Z","timestamp":1620950400000},"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":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate rates of recurrent instability in adolescent patients with medial patellofemoral ligament (MPFL) reconstruction with allograft and associations of anatomic risk factors with complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review identified patients of a single surgeon who underwent MPFL reconstruction with allograft for recurrent patellar instability with minimum 2\u2010year follow\u2010up. Surgical management was recommended after a minimum 6 weeks of nonoperative management and included MPFL reconstruction with gracilis allograft using a double\u2010bundle technique. Preoperative radiographs were evaluated to assess physeal closure, lower\u2010extremity alignment, trochlear morphology, and Insall\u2010Salvati and Caton\u2010Deschamps ratios. Magnetic resonance images were reviewed to evaluate the MPFL, trochlear morphology, and tibial tubercle trochlear groove distance (TT\u2010TG). Descriptive statistics were used to characterize data. The primary outcome was recurrent instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>20 patients (24 knees; 18 knees in 14 females and 6 knees in 6 males; average age 15.7 years; range 11.5 to 19.6) underwent MPFL reconstruction with allograft (mean \u00b1 standard deviation follow\u2010up 5.2 \u00b1 1.7 years; range 2.2 to 8.1). Physes were open in 9 knees. The Insall\u2010Salvati ratio was 1.09 \u00b1 0.16, and the Caton\u2010Deschamps index was 1.17 \u00b1 0.15. Preoperatively, 19 patients were noted to have trochlear dysplasia, and TT\u2010TG was 15.3 \u00b1 3.9 mm. Three of 4 knees (16.7%) with non\u2013hardware\u2010related complications had open physes: 3 (12.5%) had recurrent instability, 2 of which underwent subsequent operation, and 1 sustained a patella fracture after a fall, requiring open reduction and internal fixation. The average Insall\u2010Salvati ratio of these 4 patients was 1.21 \u00b1 0.20, Caton\u2010Deschamps index was 1.18 \u00b1 0.17, and TT\u2010TG was 17.5 \u00b1 3.3 mm, none of which were statistically different from the group without complications. There were no clinically noted growth disturbances postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MPFL reconstruction using allograft tissue may be performed safely in the pediatric and adolescent population with good outcomes at midterm follow\u2010up, few complications, and a low rate of recurrent instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2021.05.005","type":"journal-article","created":{"date-parts":[[2021,5,15]],"date-time":"2021-05-15T06:51:37Z","timestamp":1621061497000},"page":"128-138","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":18,"title":["Allograft Medial Patellofemoral Ligament Reconstruction in Adolescent Patients Results in a Low Recurrence Rate of Patellar Dislocation or Subluxation at Midterm Follow\u2010Up"],"prefix":"10.1002","volume":"38","author":[{"given":"Sachin","family":"Allahabadi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery University of California San Francisco San Francisco California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirav K.","family":"Pandya","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Benioff Children\u2019s Hospital Oakland University of California San Francisco San Francisco California 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