{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:39:47Z","timestamp":1793723987687,"version":"4.6.1"},"reference-count":30,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:00:00Z","timestamp":1739318400000},"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":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Radiological risk factors for an osteochondral fracture (OCF) associated with patellar instability are rarely studied, particularly in patients with recurrent instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To identify specific radiological characteristics that relate to the increased prevalence of OCFs associated with patellar instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Case-control study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patient data (n = 730) from the Justifying Patellar Instability Treatment by Early Results (JUPITER) multicenter study were reviewed for radiological findings. Trochlear crossing sign, Caton-Deschamps index (CDI), tibial tubercle\u2013trochlear groove (TT-TG) distance, patellar tilt, trochlear depth, trochlear bump, sulcus angle, and patellar subluxation were measured on radiography or magnetic resonance imaging and classified into 2 categories based on pathological thresholds for general patellar instability. Patients were grouped according to the presence or absence of an OCF and analyzed with the Mann-Whitney test, chi-square test, and multivariate regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A high CDI was associated with a 0.43 decreased odds of an OCF, while a high TT-TG distance was a risk factor for an OCF, with a 2.17 times increased odds. Although a first-time dislocation increased the odds of an OCF by 4.72 times, recurrent instability was found to have the same predictive relationship of CDI and TT-TG distance with fracture incidence. A lower CDI, a shallower trochlear depth, a smaller trochlear bump, and the presence of a patellar subluxation were more common in patients with OCFs. A lower CDI, positive trochlear crossing sign, and shallower trochlear depth were more common in the subset of patients with recurrent instability and associated OCFs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Patella alta was protective of OCFs in patients with first-time and recurrent instability, while a lateralized tibial tubercle was a risk factor. These radiological characteristics should guide health care professionals on the risk of future OCFs during treatment planning after a patellar instability event.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465251315170","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T23:34:36Z","timestamp":1739403276000},"page":"839-847","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Radiological Risk Factors for Osteochondral Fractures in Patients With First-Time and Recurrent Patellar Instability: Data From the JUPITER Cohort"],"prefix":"10.1177","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4021-6362","authenticated-orcid":false,"given":"James J.","family":"McGinley","sequence":"first","affiliation":[{"name":"Center for Excellence in Sports Medicine, Scottish Rite for Children, Frisco, Texas, USA"},{"name":"Investigation performed at the Center for Excellence in Sports Medicine, Scottish Rite for Children, Frisco, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry B.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Center for Excellence in Sports Medicine, Scottish Rite for Children, Frisco, Texas, USA"},{"name":"Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA"},{"name":"Investigation performed at the Center for Excellence in Sports Medicine, Scottish Rite for Children, Frisco, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bennett","family":"Propp","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA"},{"name":"Investigation performed at the Center for Excellence in Sports Medicine, Scottish Rite for Children, Frisco, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W.","family":"Veerkamp","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio, USA"},{"name":"Investigation performed at the Center for Excellence in Sports Medicine, Scottish Rite for Children, Frisco, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip L.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Center for Excellence in Sports Medicine, Scottish Rite for Children, Frisco, Texas, USA"},{"name":"Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA"},{"name":"Investigation performed at the Center for Excellence in Sports Medicine, Scottish Rite for Children, Frisco, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8560-633X","authenticated-orcid":false,"given":"Dennis E.","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"Investigation performed at the Center for Excellence in Sports Medicine, Scottish Rite for Children, Frisco, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benton E.","family":"Heyworth","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Sports Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"Investigation performed at the Center for Excellence in Sports Medicine, Scottish Rite for Children, Frisco, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Strickland","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA"},{"name":"Investigation performed at the Center for Excellence in Sports 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