{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:45:43Z","timestamp":1793317543866,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"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":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare postoperative complication rates between patients who underwent medial patellofemoral ligament reconstruction (MPFLR) and those who underwent MPFLR with tibial tubercle osteotomy (TTO) in a large\u2010scale study. A secondary goal was to investigate demographic associations with outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent MPFLR (n\u00a0= 3,480) or MPFLR\u2010TTO (n\u00a0= 615) for patellar instability were identified in the PearlDiver database. Rates of surgery for infection, procedures for knee stiffness, patellar fracture, and revision MPFLR within 2 years postoperatively were compared using multivariable logistic regression. Demographic associations with outcomes were also investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The MPFLR\u2010TTO cohort exhibited a significantly lower rate of revision surgery at 2 years (0.8% vs 1.9%; odds ratio [OR], 0.33; 95% confidence interval [CI], 0.10\u20100.80;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .036) when compared with the MPFLR group. Independent of index procedure, patients younger than 21 years had significantly lower rates of requiring procedures for knee stiffness (OR, 0.35; 95% CI, 0.22\u20100.54;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and any complication at 2\u00a0years (OR, 0.59; 95% CI, 0.45\u20100.78;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) when compared with older patients. Male patients displayed a significantly lower rate of requiring procedures for knee stiffness at 2 years than female patients (OR, 0.46; 95% CI, 0.25\u20100.78;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .007). Tobacco use was associated with a significantly higher rate of postoperative infection at 2 years (OR, 2.35; 95% CI, 1.00\u20105.38;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .046).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The MPFLR cohort exhibited higher rates of revision surgery at 2 years compared with the MPFLR\u2010TTO cohort. Patient age under 21 years was associated with lower rates of any complication and requiring procedures for knee stiffness, male sex was associated with a lower rate of requiring procedures for knee stiffness, and tobacco use was associated with a higher rate of surgery for postoperative infection. This information can assist surgeons when counseling patients before these procedures are performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective, comparative prognostic trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2023.02.006","type":"journal-article","created":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T02:15:04Z","timestamp":1676686504000},"page":"2037","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":25,"title":["Concomitant Tibial Tubercle Osteotomy Reduces the Risk of Revision Surgery After Medial Patellofemoral Ligament Reconstruction for the Treatment of Patellar Instability"],"prefix":"10.1002","volume":"39","author":[{"given":"Patrick C.","family":"Ryan","sequence":"first","affiliation":[{"name":"Tulane University School of Medicine New Orleans Louisiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bailey J.","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Emory School of Medicine Atlanta Georgia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela A.","family":"Stamm","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Tulane University School of Medicine New Orleans Louisiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William F.","family":"Sherman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Tulane University School of Medicine New Orleans Louisiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendell M.R.","family":"Heard","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Tulane University School of Medicine New Orleans Louisiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary K.","family":"Mulcahey","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Tulane University School of Medicine New Orleans Louisiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,17]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2019.11.007"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5266-y"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0000000000000252"},{"key":"e_1_2_3_5_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1579675"},{"key":"e_1_2_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0000000000000145"},{"key":"e_1_2_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967116662873"},{"key":"e_1_2_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120946446"},{"key":"e_1_2_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211063176"},{"key":"e_1_2_3_10_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.O.00354"},{"key":"e_1_2_3_11_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-122855"},{"key":"e_1_2_3_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-021-02383-9"},{"key":"e_1_2_3_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967119855023"},{"key":"e_1_2_3_14_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.K.01449"},{"key":"e_1_2_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2015.11.039"},{"key":"e_1_2_3_16_2","volume-title":"StatPearls. 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