{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:53:21Z","timestamp":1792022001246,"version":"4.4.0"},"reference-count":47,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T00:00:00Z","timestamp":1735948800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Ministerial commission of science and technology","award":["JK-2022-07"],"award-info":[{"award-number":["JK-2022-07"]}]},{"name":"Clinical Key Program from Peking University Third Hospital","award":["BYSYZD2021021"],"award-info":[{"award-number":["BYSYZD2021021"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is a lack of evidence and continuous debate on whether femoral tunnel displacement substantially influences the clinical efficacy of medial patellofemoral ligament reconstruction (MPFL-R) in addressing recurrent patellar dislocation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To investigate possible associations between inaccurate femoral tunnel placement during MPFL-R and clinical outcomes, with a specific focus on proximal tunnel malpositioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Patients who were diagnosed with recurrent patellar dislocation and underwent MPFL-R were retrospectively analyzed. A true lateral view on 3-dimensional computed tomography was obtained, and the distance from the center of the femoral tunnel to the Sch\u00f6ttle point (D\n                      <jats:sub>F-to-S<\/jats:sub>\n                      ) was measured. Accordingly, femoral tunnels were divided into the suboptimal group (D\n                      <jats:sub>F-to-S<\/jats:sub>\n                      &gt; 10 mm) and the optimal group (D\n                      <jats:sub>F-to-S<\/jats:sub>\n                      \u2264 10 mm). Patient data were collected and pathoanatomic risk factors were evaluated. Clinical assessments included patient-reported outcome measures, including the International Knee Documentation Committee (IKDC), Kujala, Lysholm, and Tegner scores; subjective satisfaction; and postoperative complications. A subgroup analysis was performed between proximally malpositioned tunnels and tunnels lying in other directions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 112 patients (112 knees) were included, with 34 in the suboptimal group and 78 in the optimal group. Patient characteristics and pathoanatomic abnormalities were comparable between the 2 arms, with mean follow-ups of 52.90 \u00b1 23.80 months and 60.14 \u00b1 27.88 months in the suboptimal and optimal groups, respectively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .259). At the final follow-up, inferior IKDC (76.3 \u00b1 12.8 vs 85.9 \u00b1 6.3;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), Kujala (87.7 \u00b1 9.3 vs 93.8 \u00b1 4.9;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001), and Lysholm (87.0 \u00b1 11.8 vs 94.5 \u00b1 5.3;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001) scores and subjective satisfaction (8.2 \u00b1 1.4 vs 9.3 \u00b1 0.9;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) were observed in the suboptimal group compared with the optimal group. Lower proportions of patients met the minimal clinically important difference for the IKDC (82.4% vs 100.0%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001) and Lysholm (79.4% vs 98.7%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001) scores in the suboptimal group compared with the optimal group. Subgroup analysis demonstrated that the final IKDC (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002), Kujala (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001), and Lysholm (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001) scores and subjective satisfaction (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .031) were statistically worse in the proximally located group, with insignificant improvements compared with preoperative levels. The suboptimal group showed a higher rate of overall complications, and anterior knee pain was more often reported in the proximally located subgroup.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Inaccurate femoral tunnel positioning was associated with inferior midterm subjective functional scores and a higher rate of postoperative complications after MPFL-R. Proximal displacement in particular was associated with adverse clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465241303514","type":"journal-article","created":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T04:01:18Z","timestamp":1735963278000},"page":"360-371","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["The Effects of Inaccurate Femoral Tunnel Placement During Medial Patellofemoral Ligament Reconstruction on Midterm Clinical Outcomes in Treatment of Recurrent Patellar Dislocation"],"prefix":"10.1177","volume":"53","author":[{"given":"Fengyi","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Sports Medicine, Peking University Third Hospital; Institute of Sports Medicine of Peking University; Beijing Key Laboratory of Sports Injuries, Beijing, 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