{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T23:45:54Z","timestamp":1791589554135,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"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\/100019075","name":"Association of Bone and Joint Surgeons","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019075","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013880","name":"Ruth Jackson Orthopaedic Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013880","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005382","name":"American Orthopaedic Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005382","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011549","name":"American Orthopaedic Society for Sports Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011549","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009885","name":"American Academy of Orthopaedic Surgeons","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009885","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"}]}],"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":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To analyze factors that affect return to sport after medial patellofemoral ligament reconstruction (MPFLR), such as psychological factors, sport played, and a positive apprehension test following surgery, and to determine the average return to sport rates and time to return to sport.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses guidelines. Included studies met the following criteria: patients underwent MPFLR for patellar instability, return to sport was recorded, and a factor that affected return to sport was mentioned. Search terms included medial patellofemoral ligament, tibial tubercle osteotomy, tibial tubercle transfer, return to play, and return to sport.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighteen of 632 identified studies met inclusion criteria, and 1,072 patients who underwent MFPLR were recorded. Return\u2010to\u2010sport rates and mean\/median time ranged from 60.0% to 100% and 3 to 10.4 months, respectively. Of the patients, 55.6% to 84.0% returned to sport without decreasing the level of competition. Six of 12 studies (50.0%) reported fear of reinjury as the top reason for patients not returning or returning at a lower level of sport. Volleyball\/handball had the lowest return to the same level following surgery (18.2%\u201050.0%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Athletes who underwent MPFLR following recurrent patellar instability returned to sport at a range of 60.0% to 100%. Return to sport at the same level or higher was found to have a lower maximum rate at 55.6% to 84.0%. Fear of reinjury and sport played were found to have a substantial impact on ability to return to sport. Surgeons can use this information to advise patients on expectations following surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, systematic review of Level III and IV studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2024.05.022","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T06:56:54Z","timestamp":1717657014000},"page":"1605-1617","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":12,"title":["Fear of Reinjury, Psychological Factors, and Sport Played Have Negative Impact on Return to Sport Following Medial Patellofemoral Ligament Reconstruction for Patellar Instability"],"prefix":"10.1002","volume":"41","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":"Idaleen C.","family":"Ching","sequence":"additional","affiliation":[{"name":"Tulane University School of Medicine New Orleans Louisiana U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria K.","family":"Ierulli","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":"Keith","family":"Pickett","sequence":"additional","affiliation":[{"name":"Rudolph Matas Library of the Health Sciences 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 Orthopedic Surgery and Rehabilitation Loyola University Medical Center Maywood Illinois 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