{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:17:08Z","timestamp":1787019428510,"version":"build-2736575974"},"reference-count":42,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"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":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Patellofemoral instability (PFI) has several known anatomic factors, including trochlear dysplasia and patellar maltracking. While studies have documented altered lower-extremity gait biomechanics in patients with PFI, the relationship between these biomechanical abnormalities and anatomy has not been thoroughly investigated, particularly during sport-related tasks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose\/Hypothesis:<\/jats:title>\n                    <jats:p>The purpose of this study is to examine the associations between preoperative anatomic characteristics and lower-extremity kinematics at sports clearance in adolescents after medial patellofemoral ligament reconstruction for PFI. It was hypothesized that patellar maltracking, trochlear dysplasia, and frontal plane malalignment would strongly correlate with abnormal lower-extremity biomechanics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Descriptive laboratory study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients aged 10 to 18 years who underwent primary medial patellofemoral ligament reconstruction for PFI between 2019 and 2023 were tested at sports clearance visits. Joint angles of the hip and knee were calculated during descent of a drop vertical jump. Preoperative radiographs and magnetic resonance imaging were utilized to record tibial tuberosity\u2013trochlear groove (TT-TG) distance, tibial tubercle\u2013posterior cruciate ligament (TT-PCL) distance, trochlear width (TW), trochlear sulcus depth (TSD), lateral inclination angle, patellar tilt angle (PTA), Caton-Deschamps Index (CDI), and femorotibial angle. Spearman correlations assessed relationships between preoperative anatomy and drop vertical jump kinematics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In total, 17 participants were tested (8 male, 15 unilateral; mean \u00b1 SD age, 15.5 \u00b1 1.4 years; height, 166.3 \u00b1 11.4 cm; weight, 65.1 \u00b1 19.4 kg; days after surgery, 199.9 \u00b1 30.8). TT-PCL, TT-TG, and TSD were not significantly correlated with kinematics. Greater dynamic pelvic obliquity (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.672;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .004) and internal pelvic rotation (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.508;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .044) were positively correlated with femorotibial angle. Pelvic obliquity was negatively correlated with CDI (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = \u22120.710;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .007). Greater severity of patellar malalignment and trochlear dysplasia (decreased TW,\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = \u22120.486 [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .048]; increased PTA,\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.689 [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002]) was associated with greater hip abduction. TW (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.503;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .040) and CDI (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = \u22120.608;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .028) were also correlated with internal hip rotation. Greater knee flexion during landing was correlated with decreased PTA (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = \u22120.547;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .023) and CDI (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = \u22120.560;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .046). Greater dynamic knee valgus was positively correlated with TW (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.483;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .049), and greater internal knee rotation was positively correlated with lateral inclination angle (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.513;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .035).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Larger degree of patellar maltracking, trochlear dysplasia, and frontal plane malalignment correlated to distinct biomechanical patterns during dynamic movements. Statistically significant associations were found with internal knee and hip rotation, pelvic instability, hip abduction, and knee stiffness. Conversely, TT-PCL, TT-TG, and TSD demonstrated no significant association with postoperative kinematic patterns in patients with PFI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>Understanding how anatomic abnormalities relate to postoperative biomechanics can help clinicians identify adolescents at risk for persistent movement deficits after medial patellofemoral ligament reconstruction. These findings highlight the importance of incorporating individualized anatomic considerations into postoperative rehabilitation and return-to-sport assessments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671251383076","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T13:54:58Z","timestamp":1761054898000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Patellofemoral Joint Anatomy Is Associated With Landing Mechanics After Operative Treatment for Patellar Instability"],"prefix":"10.1177","volume":"13","author":[{"given":"Zachariah","family":"Samuel","sequence":"first","affiliation":[{"name":"CUNY School of Medicine, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6262-2054","authenticated-orcid":false,"given":"Sophia","family":"Ulman","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas, USA"},{"name":"University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4021-6362","authenticated-orcid":false,"given":"James J.","family":"McGinley","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Emerson","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuck","family":"Wyatt","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas, USA"},{"name":"University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex M.","family":"Loewen","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4246-2361","authenticated-orcid":false,"given":"Ashley L.","family":"Erdman","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry B.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas, USA"},{"name":"University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip L.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Scottish Rite for Children, Frisco, Texas, USA"},{"name":"University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-022-04703-y"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2016.02.005"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-476-18"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2023.02.006"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515602483"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001035"},{"issue":"4","key":"e_1_3_2_8_2","first-page":"128","article-title":"MPFL reconstruction: indications and results","volume":"91","author":"Dall\u2019Oca C","year":"2020","unstructured":"Dall\u2019Oca C, Elena N, Lunardelli E, Ulgelmo M, Magnan B. MPFL reconstruction: indications and results. Acta Biomed. 2020;91(4-S):128-135.","journal-title":"Acta Biomed"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-022-09746-7"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2019.11.018"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.00688"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e3181f744f5"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-021-02527-x"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4799-9"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.L.00989"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.23736\/S0026-4946.17.04882-4"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191710491"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546504269591"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231164400"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13244-019-0755-1"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/7452229"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2021.0577"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1589\/jpts.33.511"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0193487"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06382-x"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2020.05.008"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-015-3948-2"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrnm.2016.09.020"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000001080"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.22.00054"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2010.3337"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.08.256"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2022.08.039"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515624673"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512438762"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/BLO.0b013e31802eb40a"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-013-2942-6"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2021.11.030"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4795-0"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001697"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-020-09626-y"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2307-9"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1111\/os.12766"}],"container-title":["Orthopaedic Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671251383076","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259671251383076","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671251383076","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:30:05Z","timestamp":1777595405000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259671251383076"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":42,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1177\/23259671251383076"],"URL":"https:\/\/doi.org\/10.1177\/23259671251383076","relation":{},"ISSN":["2325-9671","2325-9671"],"issn-type":[{"value":"2325-9671","type":"print"},{"value":"2325-9671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"article-number":"23259671251383076"}}