{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:29:29Z","timestamp":1777588169072,"version":"3.51.4"},"reference-count":30,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"8","license":[{"start":{"date-parts":[[2012,8,1]],"date-time":"2012-08-01T00:00:00Z","timestamp":1343779200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["Bone &amp; Joint Research"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the effectiveness of a modified tibial tubercle osteotomy as a treatment for arthroscopically diagnosed chondromalacia patellae.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 47 consecutive patients (51 knees) with arthroscopically proven chondromalacia, who had failed conservative management, underwent a modified Fulkerson tibial tubercle osteotomy. The mean age was 34.4 years (19.6 to 52.2). Pre-operatively, none of the patients exhibited signs of patellar maltracking or instability in association with their anterior knee pain. The minimum follow-up for the study was five years (mean 72.6 months (62 to 118)), with only one patient lost to follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 50 knees were reviewed. At final follow-up, the Kujala knee score improved from 39.2 (12 to 63) pre-operatively to 57.7 (16 to 89) post-operatively (p &lt; 0.001). The visual analogue pain score improved from 7.8 (4 to 10) pre-operatively to 5.0 (0 to 10) post-operatively. Overall patient satisfaction with good or excellent results was 72%. Patients with the lowest pre-operative Kujala score benefitted the most. Older patients benefited less than younger ones. The outcome was independent of the grade of chondromalacia. Six patients required screw removal. There were no major complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We conclude that this modification of the Fulkerson procedure is a safe and useful operation to treat anterior knee pain in well aligned patellofemoral joints due to chondromalacia patellae in adults, when conservative measures have failed.<\/jats:p><\/jats:sec>","DOI":"10.1302\/2046-3758.18.2000083","type":"journal-article","created":{"date-parts":[[2013,7,25]],"date-time":"2013-07-25T21:37:20Z","timestamp":1374788240000},"page":"167-173","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":19,"title":["The modified tibial tubercle osteotomy for anterior knee pain due to chondromalacia patellae in adults"],"prefix":"10.1302","volume":"1","author":[{"given":"C. M.","family":"Jack","sequence":"first","affiliation":[{"name":"Conquest Hospital, The Ridge, St Leonards-on-Sea, East Sussex TN37 7RD, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. S.","family":"Rajaratnam","sequence":"additional","affiliation":[{"name":"Eastbourne District General Hospital, Kings Drive, Eastbourne, East Sussex BN21 2UD, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. O.","family":"Khan","sequence":"additional","affiliation":[{"name":"Conquest Hospital, The Ridge, St Leonards-on-Sea, East Sussex TN37 7RD, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Keast-Butler","sequence":"additional","affiliation":[{"name":"Conquest Hospital, The Ridge, St Leonards-on-Sea, East Sussex TN37 7RD, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. A.","family":"Butler-Manuel","sequence":"additional","affiliation":[{"name":"Conquest Hospital, The Ridge, St Leonards-on-Sea, East Sussex TN37 7RD, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. W.","family":"Heatley","sequence":"additional","affiliation":[{"name":"Conquest Hospital, The Ridge, St Leonards-on-Sea, East Sussex TN37 7RD, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"42","reference":[{"key":"r1","doi-asserted-by":"crossref","unstructured":"Kipnis J, Scuderi GR.A historic review of patellar pain. In: Scuderi GR, ed.The patella. Springer-Verlag, 1995:1\u20137.","DOI":"10.1007\/978-1-4612-4188-1_1"},{"key":"r2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197052020-00002"},{"key":"r3","doi-asserted-by":"crossref","unstructured":"Benninghoff A.Form und Bann der Gelenkknorpel in inhren Beziehungren zur Funktion. Zweiter Teli: Zeitschrift fur Zellforschung und Mikroskopishe Anatromie.Z Zellforsch1925;2:783 (in German).","DOI":"10.1007\/BF00583443"},{"key":"r4","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.74B3.1587902"},{"key":"r5","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198870060-00014"},{"key":"r6","first-page":"779","volume":"30","author":"Maquet P","year":"1963","journal-title":"Rev Rhum Mal Osteoartic"},{"key":"r7","first-page":"225","volume":"115","author":"Maquet P","year":"1976","journal-title":"Clin Orthop Relat Res"},{"key":"r8","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197961020-00001"},{"key":"r9","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.43B4.752"},{"key":"r10","doi-asserted-by":"publisher","DOI":"10.1177\/036354659001800508"},{"key":"r11","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1097\/00003086-198307000-00027","volume":"177","author":"Fulkerson JP","year":"1983","journal-title":"Clin Orthop Relat Res"},{"key":"r12","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(05)80366-4"},{"key":"r13","doi-asserted-by":"publisher","DOI":"10.1177\/03635465000280051201"},{"key":"r14","doi-asserted-by":"publisher","DOI":"10.1177\/03635465020300061701"},{"key":"r15","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.60B1.627583"},{"key":"r16","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9993(94)90089-2"},{"key":"r17","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100060405"},{"key":"r18","first-page":"60","volume":"87","author":"Chakraverty AC","year":"1972","journal-title":"Bristol Med Chir J"},{"key":"r19","doi-asserted-by":"publisher","DOI":"10.3109\/17453678208992191"},{"key":"r20","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000238831.50186.87"},{"key":"r21","unstructured":"Roux C.Luxation habituelle de la rotule: traitment operatoire.Rev Chir Orthop Reparatrice Appar Mot1888;8:682\u2013689 (in French)."},{"key":"r22","first-page":"813","volume":"50","author":"Trillat A","year":"1964","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"key":"r23","first-page":"1297","volume":"102","author":"Bandi W","year":"1977","journal-title":"Zentralbl Chir"},{"key":"r24","doi-asserted-by":"publisher","DOI":"10.1007\/BF01477260"},{"key":"r25","doi-asserted-by":"publisher","DOI":"10.3109\/17453678008990861"},{"key":"r26","first-page":"342","volume":"25","author":"Hadjipavlou A","year":"1982","journal-title":"Can J Surg"},{"key":"r27","first-page":"13","volume":"7","author":"Schepsis AA","year":"1994","journal-title":"Am J Knee Surg"},{"key":"r28","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1097\/00003086-198607000-00039","volume":"208","author":"Heatley FW","year":"1986","journal-title":"Clin Orthop Relat Res"},{"key":"r29","first-page":"37","volume":"13","author":"Silvello L","year":"1987","journal-title":"Ital J Orthop Traumatol"},{"key":"r30","doi-asserted-by":"publisher","DOI":"10.1053\/otsm.2000.6581"}],"container-title":["Bone &amp; Joint Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/2046-3758.18.2000083","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/full-xml\/10.1302\/2046-3758.18.2000083","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/2046-3758.18.2000083","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T04:24:27Z","timestamp":1646195067000},"score":1,"resource":{"primary":{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/10.1302\/2046-3758.18.2000083"}},"subtitle":["A five-year prospective study"],"short-title":[],"issued":{"date-parts":[[2012,8]]},"references-count":30,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2012,8]]}},"alternative-id":["10.1302\/2046-3758.18.2000083"],"URL":"https:\/\/doi.org\/10.1302\/2046-3758.18.2000083","relation":{},"ISSN":["2046-3758"],"issn-type":[{"value":"2046-3758","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,8]]},"assertion":[{"value":"2012-04-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-05-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-08-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}