{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T04:20:48Z","timestamp":1785817248426,"version":"3.56.0"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["arthroscopytechniques.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["arthrosc. tech."],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Ehlers\u2010Danlos syndrome often presents with patellofemoral instability and, less commonly, proximal tibiofibular joint (PTFJ) instability, leading to compounded symptoms and functional impairment. This Technical Note describes a combined surgical approach for managing dual instability in patients with Ehlers\u2010Danlos syndrome, involving medial patellofemoral ligament reconstruction and tibial tubercle osteotomy, in conjunction with PTFJ stabilization using an adjustable\u2010loop cortical suspension device. This technique addresses biomechanical abnormalities and improves joint stability. Postoperative rehabilitation emphasizes controlled mobilization and progressive weightbearing. This comprehensive approach optimizes functional outcomes in patients with complex patellofemoral instability and PTFJ.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Technique Video<\/jats:title>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"video\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" position=\"anchor\" xlink:href=\"urn:x-wiley:22126287:media:atn2bf04019:atn2bf04019-vimg-0001\">\n                          <jats:alt-text>video<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>See video under supplementary data.<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.eats.2025.103902","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T04:21:24Z","timestamp":1760070084000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgical Management of Combined Patellofemoral and Proximal Tibiofibular Joint Instability in a Patient With Ehlers\u2010Danlos Syndrome"],"prefix":"10.1002","volume":"14","author":[{"given":"Sebastian","family":"Schmidt","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Brigham and Women\u2019s Hospital Harvard Medical School Boston Massachusetts U.S.A."},{"name":"Department of Orthopaedic and Trauma Surgery University Medical Centre Mannheim Medical Faculty Mannheim University of Heidelberg Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chilan B.G.","family":"Leite","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Brigham and Women\u2019s Hospital Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Franco","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Brigham and Women\u2019s Hospital Harvard Medical School Boston Massachusetts U.S.A."},{"name":"Operative Research Unit of Orthopaedic and Trauma Surgery Fondazione Policlinico Universitario Campus Bio\u2010Medico Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Protzuk","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Brigham and Women\u2019s Hospital Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Sherman","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Brigham and Women\u2019s Hospital Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Lattermann","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Brigham and Women\u2019s Hospital Harvard Medical School Boston Massachusetts 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