{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T04:21:24Z","timestamp":1793766084989,"version":"4.6.1"},"reference-count":20,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Patellofemoral instability is associated with chondral injuries to the patella, trochlea, and lateral femoral condyle. Although studies have demonstrated an association between patellar dislocations and chondral injuries, the influence of the number of dislocations on chondrosis is not established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To elucidate the precise association between the number of patellar dislocation events and the severity of chondral injuries in a multicenter cohort study at the time of patellar stabilization procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cross-sectional study; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective multicenter cohort study (JUPITER [Justifying Patellar Instability Treatment by Early Results]) database was queried for cases of primary patellofemoral instability procedures from December 2016 to September 2022. Cartilage lesions were classified using the International Cartilage Repair Society (ICRS) classification system during an arthroscopic or open evaluation (direct visualization), with grades 2 to 4 considered abnormal. The number of dislocations was categorized as 1, 2-5, and &gt;5. Categorical variables were compared with the chi-square test, and binary logistic regression was performed to identify predictors of the presence of chondral lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 938 knees (mean age, 16.2 \u00b1 3.8 years; 61.4% female) were included, with 580 (61.8%) demonstrating a chondral injury. The most affected region was the patella (n = 498 [53.1%]), followed by the lateral femoral condyle (n = 117 [12.5%]) and trochlea (n = 109 [11.6%]). There were no differences in the presence ( P = .17) or grade ( P = .63) of patellar lesions by the number of dislocations. Patients with &gt;5 dislocations more frequently had trochlear chondral lesions (19.8%) compared with those with fewer dislocations (1, 7.6%; 2-5, 11.0%; P &lt; .001). More dislocations were also associated with a higher proportion of ICRS grade 2 to 4 trochlear lesions (&gt;5, 15.3%; 2-5, 10.0%; 1, 6.9%; P = .015). Combined patellar and trochlear lesions were also more common in those with &gt;5 dislocations ( P = .001). In multivariable regression, &gt;5 dislocations was the only variable predictive of a trochlear lesion (odds ratio, 3.03 [95% CI, 1.65-5.58]; P &lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This large prospective cohort study demonstrated that recurrent patellar dislocations can lead to more severe chondral damage in specific locations in the knee. More than 5 dislocations was associated with a &gt;3-fold increase in the incidence and severity of trochlear chondral injuries. There were no differences in the presence or grade of patellar lesions by the number of dislocations. These findings should caution surgeons regarding prolonged nonoperative treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465241261968","type":"journal-article","created":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T08:12:47Z","timestamp":1722845567000},"page":"2541-2546","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["The Number of Patellar Dislocation Events Is Associated With Increased Chondral Damage of the Trochlea"],"prefix":"10.1177","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3913-2804","authenticated-orcid":false,"given":"Joshua T.","family":"Bram","sequence":"first","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Lijesen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W.","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2572-1344","authenticated-orcid":false,"given":"Benton E.","family":"Heyworth","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W.","family":"Veerkamp","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle E.","family":"Chipman","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bennett E.","family":"Propp","sequence":"additional","affiliation":[{"name":"Women\u2019s Sports Medicine Center, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline M.","family":"Brady","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shital N.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth E.","family":"Shubin Stein","sequence":"additional","affiliation":[{"name":"Women\u2019s Sports Medicine Center, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"JUPITER Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina M.","family":"Strickland","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"Fabricant","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason L.","family":"Koh","sequence":"additional","affiliation":[{"name":"Northshore, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Farr","sequence":"additional","affiliation":[{"name":"OrthoIndy, Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Meng","family":"Yen","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis E.","family":"Kramer","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"Milewski","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Wall","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.","family":"Tompkins","sequence":"additional","affiliation":[{"name":"TRIA Orthopedics, Minneapolis, Minnesota, 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam B.","family":"Yanke","sequence":"additional","affiliation":[{"name":"Midwest Orthopedics at RUSH, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth L.","family":"Sherman","sequence":"additional","affiliation":[{"name":"Stanford University, Standford, California, USA"},{"name":"Investigation performed at the Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,8,5]]},"reference":[{"issue":"3","key":"bibr1-03635465241261968","volume":"11","author":"Farrow L","year":"2023","journal-title":"Orthop J Sports Med"},{"key":"bibr2-03635465241261968","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1313747"},{"issue":"2","key":"bibr3-03635465241261968","volume":"4","author":"Hadley CJ","year":"2022","journal-title":"Sports Med Arthrosc Rehabil Ther 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