{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T06:33:32Z","timestamp":1787898812314,"version":"build-2784847793"},"reference-count":22,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thekneejournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Knee"],"published-print":{"date-parts":[[2026,3]]},"DOI":"10.1016\/j.knee.2025.104302","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T13:02:51Z","timestamp":1766235771000},"page":"104302","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"special_numbering":"C","title":["External rotation of the patellar tendon insertion line: A novel predictor for recurrent patellar dislocation"],"prefix":"10.1016","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7160-267X","authenticated-orcid":false,"given":"Yasuhito","family":"Sogi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8878-7275","authenticated-orcid":false,"given":"Masahiro","family":"Ohnuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kento","family":"Chikazawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Kashiwaba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Ogasawara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiko","family":"Sugita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshimi","family":"Aizawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.knee.2025.104302_b0005","doi-asserted-by":"crossref","DOI":"10.1177\/23259671241276446","article-title":"Ratio of tibial tubercle-trochlear groove distance to patellar width as a predictor of patellar dislocation: analysis of individualized tibial tubercle lateralization parameters","volume":"12","author":"Chen","year":"2024","journal-title":"Orthop J Sports Med"},{"key":"10.1016\/j.knee.2025.104302_b0010","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/BF01552649","article-title":"Factors of patellar instability: an anatomic radiographic study","volume":"2","author":"Dejour","year":"1994","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.knee.2025.104302_b0015","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/j.arthro.2024.07.002","article-title":"Editorial commentary: surgical treatment algorithm for patellofemoral recurrent instability","volume":"41","author":"Franciozi","year":"2025","journal-title":"Arthroscopy"},{"key":"10.1016\/j.knee.2025.104302_b0020","doi-asserted-by":"crossref","first-page":"3651","DOI":"10.1007\/s00167-022-06971-y","article-title":"The winking sign is an indicator for increased femorotibial rotation in patients with recurrent patellar instability","volume":"30","author":"Flury","year":"2022","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.knee.2025.104302_b0025","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.jisako.2024.05.004","article-title":"Femorotibial rotation is linearly associated with tibial tubercle-trochlear groove distance: a cadaveric study","volume":"9","author":"Pascual-Leone","year":"2024","journal-title":"J ISAKOS"},{"key":"10.1016\/j.knee.2025.104302_b0030","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.2214\/AJR.16.17007","article-title":"Variability in patellofemoral alignment measurements on MRI: influence of knee position","volume":"208","author":"Marquez-Lara","year":"2017","journal-title":"AJR Am J Roentgenol"},{"key":"10.1016\/j.knee.2025.104302_b0035","doi-asserted-by":"crossref","first-page":"2811","DOI":"10.1007\/s00167-015-3508-9","article-title":"The effect of knee flexion and rotation on the tibial tuberosity\u2013trochlear groove distance","volume":"24","author":"Camathias","year":"2016","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.knee.2025.104302_b0040","doi-asserted-by":"crossref","first-page":"3735","DOI":"10.1007\/s00167-020-06382-x","article-title":"Increased tibiofemoral rotation on MRI with increasing clinical severity of patellar instability","volume":"29","author":"Lin","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.knee.2025.104302_b0045","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1055\/s-0037-1604444","article-title":"Variations in tibial tuberosity to trochlear groove and posterior cruciate ligament distances due to tibial external and valgus rotations","volume":"31","author":"Smith","year":"2018","journal-title":"J Knee Surg"},{"key":"10.1016\/j.knee.2025.104302_b0050","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1055\/s-0035-1569478","article-title":"Radiographic and anatomic evaluation of tibial tubercle to trochlear groove distance","volume":"29","author":"Worden","year":"2016","journal-title":"J Knee Surg"},{"key":"10.1016\/j.knee.2025.104302_b0055","doi-asserted-by":"crossref","DOI":"10.1177\/23259671241239965","article-title":"Reliability of tibial tubercle\u2013trochlear groove distance for assessing tibial tubercle lateralization: a study comparing different anatomic references","volume":"12","author":"Li","year":"2024","journal-title":"Orthop J Sports Med"},{"key":"10.1016\/j.knee.2025.104302_b0060","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s12891-020-03900-3","article-title":"Defining the role of TT-TG and TT-PCL in the diagnosis of lateralization of the Tibial tubercle in recurrent patellar dislocation","volume":"22","author":"Su","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"key":"10.1016\/j.knee.2025.104302_b0065","doi-asserted-by":"crossref","first-page":"2334","DOI":"10.1007\/s00167-014-3195-y","article-title":"Anatomical factors influencing patellar tracking in the unstable patellofemoral joint","volume":"22","author":"Biyani","year":"2014","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.knee.2025.104302_b0070","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s12178-018-9480-5","article-title":"Predicting risk of recurrent patellar dislocation","volume":"11","author":"Parikh","year":"2018","journal-title":"Curr Rev Musculoskelet Med"},{"key":"10.1016\/j.knee.2025.104302_b0075","doi-asserted-by":"crossref","first-page":"2891","DOI":"10.1007\/s00167-017-4806-1","article-title":"Alignment in the transverse plane, but not sagittal or coronal plane, affects the risk of recurrent patella dislocation","volume":"26","author":"Takagi","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.knee.2025.104302_b0080","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1111\/os.13358","article-title":"The increased tibiofemoral rotation: a potential contributing factor for patellar maltracking in patients with recurrent patellar dislocation","volume":"14","author":"Wu","year":"2022","journal-title":"Orthop Surg"},{"key":"10.1016\/j.knee.2025.104302_b0085","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1177\/03635465221136535","article-title":"Factors that affect the magnitude of tibial tubercle-trochlear groove distance in patients with patellar instability","volume":"51","author":"Hevesi","year":"2023","journal-title":"Am J Sports Med"},{"key":"10.1016\/j.knee.2025.104302_b0090","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1177\/0363546513484895","article-title":"CT and MRI measurements of tibial tubercle\u2013trochlear groove distances are not equivalent in patients with patellar instability","volume":"41","author":"Camp","year":"2013","journal-title":"Am J Sports Med"},{"key":"10.1016\/j.knee.2025.104302_b0095","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/j.arthro.2022.11.021","article-title":"Patellar tendon\u2013trochlear groove angle measured on a single computed tomography slice of the distal femoral trochlear groove is a reliable measurement for the evaluation of patellar instability","volume":"39","author":"Dai","year":"2023","journal-title":"Arthroscopy"},{"key":"10.1016\/j.knee.2025.104302_b0100","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.1111\/os.13819","article-title":"Tibial tubercle\u2010trochlear groove distance has better diagnostic reliability than tubercle\u2010posterior cruciate ligament distance for predicting patellar instability: a systematic review","volume":"15","author":"Zhang","year":"2023","journal-title":"Orthop Surg"},{"key":"10.1016\/j.knee.2025.104302_b0105","doi-asserted-by":"crossref","DOI":"10.1177\/23259671221141484","article-title":"Correlation of tibial torsion with lower limb alignment and femoral anteversion in patients with patellar instability","volume":"10","author":"Qiao","year":"2022","journal-title":"Orthop J Sports Med"},{"key":"10.1016\/j.knee.2025.104302_b0110","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1007\/s00167-020-06291-z","article-title":"Increased external tibial torsion is an infratuberositary deformity and is not correlated with a lateralized position of the tibial tuberosity","volume":"29","author":"Winkler","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"}],"container-title":["The Knee"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0968016025003242?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0968016025003242?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T05:49:38Z","timestamp":1770875378000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0968016025003242"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":22,"alternative-id":["S0968016025003242"],"URL":"https:\/\/doi.org\/10.1016\/j.knee.2025.104302","relation":{},"ISSN":["0968-0160"],"issn-type":[{"value":"0968-0160","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"External rotation of the patellar tendon insertion line: A novel predictor for recurrent patellar dislocation","name":"articletitle","label":"Article Title"},{"value":"The Knee","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.knee.2025.104302","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"104302"}}