{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:55:30Z","timestamp":1777593330286,"version":"3.51.4"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"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":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To describe the clinical and radiographic outcomes of patients undergoing a lateral opening distal femur osteotomy (DFO) to address valgus alignment and restore patellar stability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of patients who underwent lateral opening DFO for recurrent patellar instability in the setting of valgus leg alignment at a single academic institution between January 2016 to December 2021 was performed. Patients without a minimum 24\u2010month postoperative follow\u2010up were excluded. Rates of recurrent patellar instability, patient\u2010reported outcomes, and complications were assessed. Pre\u2010 and postoperative radiographic anatomic lateral distal femoral angle (aLDFA) was evaluated to assess alignment correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty lateral opening DFO cases were included from 15 patients (mean age 19.6 years, mean follow\u2010up 42.4 months, range: 24\u201063 months). Nineteen of 20 (95%) knees experienced no recurrent patellar dislocation. Thirteen of 20 (65.0%) knees underwent reoperation (hardware removal, n = 10; revision stabilization procedure, n = 1; lysis of adhesions and manipulation under anesthesia, n = 1; nonunion revision with bone grafting, n = 1). Mechanical LDFA significantly changed from 86.3\u00b0 preoperatively to 91.4\u00b0 postoperatively (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Mean aLDFA changed significantly from 77.4\u00b0 preoperatively to 84.4\u00b0 postoperatively (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). The final Kujala score had a median value of 92 (interquartile range [IQR] 85.5\u201098.0), Lysholm score was 90 (IQR 76\u201095), and Tegner score was 5 (IQR 4\u20107).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lateral opening DFO is an efficacious procedure to address recurrent patellar instability in patients with valgus leg alignment. This present retrospective case series demonstrates good functional outcomes and low rates of recurrent instability and major complications after a lateral opening DFO, despite a large proportion of patients having undergone previous surgery. There were relatively high rates of reoperation and hardware irritation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, retrospective case series<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2024.12.016","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T03:00:24Z","timestamp":1734663624000},"page":"2927-2937","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"title":["Lateral Opening Distal Femoral Osteotomy With Concomitant Medial Patellofemoral Ligament Reconstruction Is Efficacious in Addressing Patellar Instability"],"prefix":"10.1002","volume":"41","author":[{"given":"Thomas E.","family":"Moran","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery University of Virginia Health System Charlottesville Virginia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brock J.","family":"Manley","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Virginia Health System Charlottesville Virginia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. Bradley","family":"Reahl","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Virginia Health System Charlottesville Virginia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pradip","family":"Ramamurti","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Virginia Health System Charlottesville Virginia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam J.","family":"Tagliero","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Virginia Health System Charlottesville Virginia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna E.","family":"Sumpter","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Virginia Health System Charlottesville Virginia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carter 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