{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:01:12Z","timestamp":1785765672681,"version":"3.56.0"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Chondral injury is a serious consequence of patellar dislocation and patellofemoral instability (PFI). There is limited data on the relationship between radiological features such as sulcus angle and patellar height to the presence, location, and severity of chondral lesions. The purpose of this study was to determine the association of anatomical variants in patellofemoral instability with injuries sustained due to patellar dislocation. A cohort of 101 patients who had four or more episodes of dislocation or instability undergoing isolated arthroscopy or arthroscopies at the time of corrective realignment surgery were identified. The prevalence of chondral, ligamentous, and meniscal injuries was determined and correlated to the sulcus angle, tibial tubercle trochlear groove distance, and patellar height on magnetic resonance imaging (MRI) scans. A total of 101 patients was identified. At arthroscopy, the patella demonstrated the highest incidence of chondral injury (68%) followed by the trochlear groove (40%). Lateral meniscal injuries were noted in 6% of patients, medial meniscal injuries in 2%, and anterior cruciate ligament (ACL) injury in 3%. Chondral injuries were graded using the Outerbridge criteria and there was a correlation between more severe chondral injuries and a greater tilt angle (p\u2009=\u20090.05). The occurrence of injury to the lateral meniscus was associated with a higher Insall\u2013Salvati ratio (p\u2009=\u20090.05). More severe chondral injuries are seen in patients with a greater tilt angle.<\/jats:p>","DOI":"10.1055\/s-0041-1731351","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T22:50:34Z","timestamp":1625007034000},"page":"153-158","source":"Crossref","is-referenced-by-count":6,"title":["Association between Patellofemoral Anatomy and Chondral Lesions of the Knee in Patellofemoral Instability"],"prefix":"10.1055","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9674-1553","authenticated-orcid":false,"given":"Olivia","family":"O'Malley","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, St George's Hospital, St George's University Hospitals National Health Service Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliya","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, St George's Hospital, St George's University Hospitals National Health Service Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Biggs","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, St George's Hospital, St George's University Hospitals National Health Service Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina J.","family":"Humdani","sequence":"additional","affiliation":[{"name":"St George's Medical School, St George's University London, St George's University Hospitals National Health Service Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, St George's Hospital, St George's University Hospitals National Health Service Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toby O.","family":"Smith","sequence":"additional","affiliation":[{"name":"Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Ejindu","sequence":"additional","affiliation":[{"name":"St George's Medical School, St George's University London, St George's University Hospitals National Health Service Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline B.","family":"Hing","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, St George's Hospital, St George's University Hospitals National Health Service Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1177\/0363546503260788","article-title":"Epidemiology and natural history of acute patellar dislocation","volume":"32","author":"D C Fithian","year":"2004","journal-title":"Am J Sports Med"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.knee.2015.06.001","article-title":"The surgical management of symptomatic articular cartilage defects of the knee: consensus statements from United Kingdom knee surgeons","volume":"22","author":"L C Biant","year":"2015","journal-title":"Knee"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.mporth.2019.01.007","article-title":"Patellofemoral instability: an overview","volume":"33","author":"P Subramanian","year":"2019","journal-title":"Orthop Trauma"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1148\/rg.304095755","article-title":"MR imaging of patellar instability: injury patterns and assessment of risk factors","volume":"30","author":"G Diederichs","year":"2010","journal-title":"Radiographics"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1007\/s00167-012-2321-y","article-title":"Evaluation of trochlear dysplasia using MRI: correlation between the classification system of Dejour and objective parameters of trochlear dysplasia","volume":"22","author":"M Nelitz","year":"2014","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"06","key":"ref6","first-page":"5438","article-title":"The significance of magnetic resonance imaging in severe femoral trochlear dysplasia assessment","volume":"14","author":"J Shen","year":"2017","journal-title":"Exp Ther Med"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1177\/1947603510397534","article-title":"Preoperative measurement of cartilage defects by MRI underestimates lesion size","volume":"2","author":"A H Gomoll","year":"2011","journal-title":"Cartilage"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/0749-8063(90)90092-R","article-title":"Chondral lesions of the patella evaluated with computed tomography, magnetic resonance imaging, and arthroscopy","volume":"6","author":"F Handelberg","year":"1990","journal-title":"Arthroscopy"},{"issue":"11","key":"ref9","doi-asserted-by":"crossref","first-page":"1728","DOI":"10.1016\/j.arthro.2012.03.018","article-title":"Sensitivity of magnetic resonance imaging for detection of patellofemoral articular cartilage defects","volume":"28","author":"J D Harris","year":"2012","journal-title":"Arthroscopy"},{"issue":"12","key":"ref10","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1007\/s00167-012-1905-x","article-title":"Accuracy of magnetic resonance imaging, magnetic resonance arthrography and computed tomography for the detection of chondral lesions of the knee","volume":"20","author":"T O Smith","year":"2012","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"10","key":"ref11","doi-asserted-by":"crossref","first-page":"2552","DOI":"10.1177\/0363546519888467","article-title":"Factors associated with an increased risk of recurrence after a first-time patellar dislocation: a systematic review and meta-analysis","volume":"48","author":"L S Huntington","year":"2020","journal-title":"Am J Sports Med"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1097\/JSA.0b013e3182553cfe","article-title":"Imaging in patellofemoral instability: an abnormality-based approach","volume":"20","author":"P R Saggin","year":"2012","journal-title":"Sports Med Arthrosc Rev"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1302\/0301-620X.43B4.752","article-title":"The etiology of chondromalacia patellae","volume":"43-B","author":"R E Outerbridge","year":"1961","journal-title":"J Bone Joint Surg Br"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1007\/s00167-005-0668-z","article-title":"Objective patellar instability: MR-based quantitative assessment of potentially associated anatomical features","volume":"14","author":"J S Escala","year":"2006","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"09","key":"ref15","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1097\/BOT.0b013e3181ed298d","article-title":"Basic science of intra-articular fractures and posttraumatic osteoarthritis","volume":"24","author":"T O McKinley","year":"2010","journal-title":"J Orthop Trauma"},{"issue":"10","key":"ref16","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1016\/j.joca.2007.03.020","article-title":"Patella malalignment, pain and patellofemoral progression: the Health ABC Study","volume":"15","author":"D J Hunter","year":"2007","journal-title":"Osteoarthritis Cartilage"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/BF01552649","article-title":"Factors of patellar instability: an anatomic radiographic study","volume":"2","author":"H Dejour","year":"1994","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"01","key":"ref18","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1177\/036354659602400110","article-title":"Acute dislocation of the patella. A correlative pathoanatomic study","volume":"24","author":"P I Sallay","year":"1996","journal-title":"Am J Sports Med"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1148\/radiol.2253011578","article-title":"Acute lateral patellar dislocation at MR imaging: injury patterns of medial patellar soft-tissue restraints and osteochondral injuries of the inferomedial patella","volume":"225","author":"D A Elias","year":"2002","journal-title":"Radiology"},{"issue":"01","key":"ref20","first-page":"17","article-title":"Medial patellofemoral ligament injury patterns and associated pathology in lateral patella dislocation: an MRI study","volume":"1","author":"P Guerrero","year":"2009","journal-title":"Sports Med Arthrosc Rehabil Ther Technol"},{"issue":"10","key":"ref21","doi-asserted-by":"crossref","first-page":"3019","DOI":"10.1007\/s00167-015-3540-9","article-title":"Meniscal tears and articular cartilage damage in the dislocated knee","volume":"23","author":"A J Krych","year":"2015","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"08","key":"ref22","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.2106\/00004623-197557080-00015","article-title":"Patella alta and patella infera. Their etiological role in patellar dislocation, chondromalacia, and apophysitis of the tibial tubercle","volume":"57","author":"J E Lancourt","year":"1975","journal-title":"J Bone Joint Surg Am"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.jor.2020.04.012","article-title":"A study of the possible effect of abnormal patella height on meniscal tears","volume":"22","author":"T Vampertzis","year":"2020","journal-title":"J Orthop"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1097\/BPO.0b013e3182a12102","article-title":"Does medial patellofemoral ligament reconstruction decrease patellar height? A preliminary report","volume":"34","author":"M G Lykissas","year":"2014","journal-title":"J Pediatr Orthop"},{"issue":"10","key":"ref25","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1007\/s00167-013-2445-8","article-title":"Treatment of patella alta in patients with episodic patellar dislocation: a systematic review","volume":"22","author":"R A Magnussen","year":"2014","journal-title":"Knee Surg Sports Traumatol Arthrosc"}],"container-title":["The Journal of Knee Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1731351.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T11:00:02Z","timestamp":1730804402000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1731351"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,29]]},"references-count":25,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2023,1,6]]},"published-print":{"date-parts":[[2023,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1731351","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1538-8506","1938-2480"],"issn-type":[{"value":"1538-8506","type":"print"},{"value":"1938-2480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,29]]}}}