{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:48:57Z","timestamp":1777880937685,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"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":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2026,2]]},"abstract":"\n Background:<\/jats:title>\n Medial patellofemoral ligament reconstruction (MPFLR) is a standard treatment for patellofemoral instability. Concomitant lateral retinacular release (LR) or lateral retinacular lengthening (LL) is considered for patients with a tight lateral retinaculum (as determined by examination under anesthesia); however, the literature is limited on the frequency of these procedures and the factors associated with their incidence.<\/jats:p>\n <\/jats:sec>\n \n Purpose:<\/jats:title>\n To investigate associations between demographic characteristics, physical examination findings, and radiologically measured patellofemoral parameters with LR\/LL in patients undergoing primary MPFLR.<\/jats:p>\n <\/jats:sec>\n \n Study Design:<\/jats:title>\n Cross-sectional study; Level of evidence, 3.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n A prospective multicenter cohort study database was queried for patients who underwent primary MPFLR between January 2017 and July 2022. A total of 23 surgeons from academic centers across the United States performed the procedures. Radiologic parameters, concomitant procedures, and pre- and intraoperative physical examination findings were assessed between patients with and without LR\/LL using the chi-square test, independent\n t<\/jats:italic>\n test, or Mann-Whitney\n U<\/jats:italic>\n test, as appropriate. Binary logistic regression was used to perform a multivariable analysis of factors associated with LR\/LL.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Of 428 patients (mean age, 16.7 \u00b1 4.2 years, 64.5% women), 22.9% underwent LR (13.6%) or LL (9.3%). Those who underwent LR\/LL were more frequently men (44% vs 23%;\n P<\/jats:italic>\n = .049), had lower Beighton scores (2.6 \u00b1 2.7 vs 3.8 \u00b1 2.9;\n P<\/jats:italic>\n < .001), and their surgeons were more likely to have completed a sports fellowship (82.7% vs 64.8%;\n P<\/jats:italic>\n < .001) compared with those who did not undergo LR\/LL. On preoperative examination, patients with LR\/LL more often exhibited patellar apprehension (92.6% vs 81.2%;\n P<\/jats:italic>\n = .008) and pathologic lateral patellar translation (62.2% vs 49.1%;\n P<\/jats:italic>\n = .012). Intraoperatively, patients with LR\/LL more often dislocated in extension during examination under anesthesia (70.4% vs 57%;\n P<\/jats:italic>\n = .017) and underwent a tibial tubercle osteotomy (TTO) (35.7% vs 9.4%;\n P<\/jats:italic>\n < .001). A total of 168 patients had preoperative imaging measurements available, and patients with LR\/LL showed greater patellar tilt (24.1\u00b0\u00b1 7.7\u00b0 vs 18.5\u00b0\u00b1 16.7\u00b0;\n P<\/jats:italic>\n < .001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Approximately 23% of patients who underwent MPLFR from a large multicenter cohort underwent LR\/LL. The LR\/LL appears to be associated with less ligamentous laxity, lateral patellar apprehension, surgeon completion of a sports fellowship, and concomitant TTO. These data may elucidate some of the relative factors associated with performing these procedures in patients undergoing primary MPFLR.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/23259671251331038","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T17:55:27Z","timestamp":1772214927000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated With the Decision to Perform a Lateral Retinacular Release or Lengthening During Medial Patellofemoral Ligament Reconstruction in the JUPITER Cohort"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3913-2804","authenticated-orcid":false,"given":"Joshua T.","family":"Bram","sequence":"first","affiliation":[{"name":"Hospital for Special Surgery, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7236-3719","authenticated-orcid":false,"given":"Emilie","family":"Lijesen","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7286-6864","authenticated-orcid":false,"given":"Daniel W.","family":"Green","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2572-1344","authenticated-orcid":false,"given":"Benton E.","family":"Heyworth","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip L.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Texas Scottish Rite Hospital for Children, Dallas, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"JUPITER GROUP:","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth E.","family":"Shubin Stein","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4391-0525","authenticated-orcid":false,"given":"Shital N.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric J.","family":"Wall","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam B.","family":"Yanke","sequence":"additional","affiliation":[{"name":"Rush University Medical Center, Chicago, IL USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3357-7183","authenticated-orcid":false,"given":"Jacqueline M.","family":"Brady","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University, Portland, OR, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4773-0890","authenticated-orcid":false,"given":"Lauren H.","family":"Redler","sequence":"additional","affiliation":[{"name":"Columbia University, New York, NY, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack","family":"Farr","sequence":"additional","affiliation":[{"name":"OrthoIndy, Indianapolis, IN, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina M.","family":"Strickland","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, New York, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8070-685X","authenticated-orcid":false,"given":"Peter D.","family":"Fabricant","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason L.","family":"Koh","sequence":"additional","affiliation":[{"name":"Northshore University, Chicago, IL, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Meng","family":"Yen","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital, Boston, Massachusetts, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"Kramer","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital, Boston, Massachusetts, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0975-1543","authenticated-orcid":false,"given":"Matthew","family":"Milewski","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital, Boston, MA USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Tompkins","sequence":"additional","affiliation":[{"name":"TRIA orthopedics, Minneapolis, MN, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6560-5244","authenticated-orcid":false,"given":"Caitlin","family":"Chambers","sequence":"additional","affiliation":[{"name":"TRIA orthopedics, Minneapolis, MN, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry","family":"Ellis","sequence":"additional","affiliation":[{"name":"Texas Scottish Rite Hospital for Children, Dallas, TX, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Wilson","sequence":"additional","affiliation":[{"name":"Texas Scottish Rite Hospital for Children, Dallas, TX, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Magnussen","sequence":"additional","affiliation":[{"name":"The Ohio State University, Columbus, OH, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seth","family":"Sherman","sequence":"additional","affiliation":[{"name":"Stanford University, Stanford, CA, USA"},{"name":"Investigation performed at Hospital for Special Surgery, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510373581"},{"issue":"2","key":"e_1_3_2_3_2","article-title":"The biomechanical effects of limited lateral retinacular and capsular release on lateral patellar translation at various flexion angles in cadaveric specimens","volume":"1","author":"Cancienne JM","year":"2019","unstructured":"Cancienne JM, Christian DR, Redondo ML, et al. The biomechanical effects of limited lateral retinacular and capsular release on lateral patellar translation at various flexion angles in cadaveric specimens. Sports Med Arthrosc Rehabil Ther Technol. 2019;1(2):e137-e144.","journal-title":"Sports Med Arthrosc Rehabil Ther Technol"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.92B1.22909"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(88)80042-2"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2021.07.007"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01552649"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2022.03.033"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2004.03.002"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671221076877"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/bpo.0b013e31815b4dcf"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2021.04.010"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0000000000000268"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2021.05.061"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-022-05013-5"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2021.0577"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0b013e318042af30"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2020.02.004"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517732045"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-018-9475-2"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5294-7"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-020-03689-9"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507313572"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507306161"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-006-0261-0"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2022.05.005"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(96)00236-3"},{"issue":"5","key":"e_1_3_2_28_2","first-page":"224","article-title":"Comparison of lateral retinaculum release and lengthening in the treatment of patellofemoral disorders","volume":"46","author":"Unal B","year":"2017","unstructured":"Unal B, Hinckel BB, Sherman SL, Lattermann C. Comparison of lateral retinaculum release and lengthening in the treatment of patellofemoral disorders. Am J Orthop . 2017;46(5):224-228.","journal-title":"Am J Orthop"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S329026"}],"container-title":["Orthopaedic Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671251331038","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259671251331038","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671251331038","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:27:10Z","timestamp":1777595230000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259671251331038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1177\/23259671251331038"],"URL":"https:\/\/doi.org\/10.1177\/23259671251331038","relation":{},"ISSN":["2325-9671","2325-9671"],"issn-type":[{"value":"2325-9671","type":"print"},{"value":"2325-9671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"article-number":"23259671251331038"}}