{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:21:27Z","timestamp":1792498887041,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T00:00:00Z","timestamp":1682467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T00:00:00Z","timestamp":1682467200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T00:00:00Z","timestamp":1682467200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T00:00:00Z","timestamp":1682467200000},"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":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To describe, in controls and in a population with patellar instability, magnetic resonance imaging values of measurements representing major associated factors for patellar instability (patellar height, trochlear dysplasia, and extensor mechanism alignment), as well as their cutoff values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In total, 323 knee magnetic resonance imaging scans, 142 with patellar instability and 181 controls without patellofemoral complaints (anterior cruciate, medial collateral ligament, meniscus ruptures or normal) were evaluated. Means, normality values in the control population, ideal cutoff values through receiver operating characteristic curves analysis, and interobserver reliability (intraclass correlation coefficient) were described for a series of measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All measurements were statistically different in control and instability patients, except for the patellotrochlear index and tibial tuberosity to posterior cruciate ligament distance. The interobserver intraclass correlation coefficient was good or excellent (above 0.75) only for the patellotrochlear index, patellar tendon\u2013trochlear groove (PTTG) angle, and patellar tilt. The optimal cutoff value for each measurement was: PTTG angle \u226525.3\n                      <jats:sup>o<\/jats:sup>\n                      with sensitivity (S) of 70% and specificity (E) of 89%, patellar tilt \u226516\n                      <jats:sup>o<\/jats:sup>\n                      (S: 69% and E: 84%), trochlear sulcus angle \u2265153\n                      <jats:sup>o<\/jats:sup>\n                      (S: 75% and E: 76%), Carrillon \u226412.8\n                      <jats:sup>o<\/jats:sup>\n                      (S: 62% and E: 87%), PTTG distance \u226511mm (S: 71% and E:\u00a078%), Caton\u2013Deschamps index \u22651.23 (S: 72% and E: 76%) and trochlear bump \u22653.95 mm (S: 76% and E: 65%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Caton\u2013Deschamps index (\u22651.23), trochlear sulcus angle (\u2265153\n                      <jats:sup>o<\/jats:sup>\n                      ), ventral prominence of the trochlea (\u22653.95 mm), PTTG distance (\u226511 mm), PTTG angle (\u226525.3\n                      <jats:sup>o<\/jats:sup>\n                      ), Carrillon angle (\u226412.8\n                      <jats:sup>o<\/jats:sup>\n                      ), and patellar tilt (\u226516\n                      <jats:sup>o<\/jats:sup>\n                      ) presented better diagnostic performance for patellar instability. Patellotrochlear index and tibial tuberosity to posterior cruciate ligament distance were not related to patellar instability. The interobserver reliability of the factors related to patellar instability was excellent only for the PTTG angle and lateral patellar tilt.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective case\u2010control study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2023.04.005","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T20:52:34Z","timestamp":1682542354000},"page":"2339-2351","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":24,"title":["Patellar Tilt and Patellar Tendon\u2013Trochlear Groove Angle Present the Optimum Magnetic Resonance Imaging Diagnostic Reliability for Patients With Patellar Instability"],"prefix":"10.1002","volume":"39","author":[{"given":"Riccardo Gomes","family":"Gobbi","sequence":"first","affiliation":[{"name":"Instituto de Ortopedia e Traumatologia Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo SP Brazil"},{"name":"Hcor S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila Maftoum","family":"Cavalheiro","sequence":"additional","affiliation":[{"name":"Instituto de Ortopedia e Traumatologia Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Nogueira","family":"Giglio","sequence":"additional","affiliation":[{"name":"Instituto de Ortopedia e Traumatologia Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betina Bremer","family":"Hinckel","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery William Beaumont Hospital Royal Oak Michigan U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilberto Luis","family":"Camanho","sequence":"additional","affiliation":[{"name":"Instituto de Ortopedia e Traumatologia Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,26]]},"reference":[{"key":"e_1_2_2_2_2","first-page":"45","article-title":"Dysplasia of the femoral trochlea","volume":"76","author":"Dejour H.","year":"1990","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"key":"e_1_2_2_3_2","first-page":"317","article-title":"Patella infera. 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