{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:43:36Z","timestamp":1788317016626,"version":"build-2803163510"},"reference-count":31,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T00:00:00Z","timestamp":1672012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The subsequent dislocation of a contralateral patellofemoral joint sometimes occurs after a first-time lateral patellar dislocation (LPD). However, the anatomic risk factors for subsequent contralateral LPD remain elusive. This study included 17 patients with contralateral LPD and 34 unilateral patellar dislocators. The anatomic parameters of the contralateral patellofemoral joints were measured using CT images and radiographs that were obtained at the time of the first dislocation. The Wilcoxon rank-sum test was performed, and a binary regression model was established to identify the risk factors. The receiver operating characteristic curves and the area under the curve (AUC) were analyzed. The tibial tubercle-Roman arch (TT-RA) distance was significantly different between patients with and without contralateral LPD (24.1 vs. 19.5 mm, p &lt; 0.001). The hip\u2013knee\u2013ankle (HKA) angle, patellar tilt, congruence angle, and patellar displacement were greater in the study group than in the control group (p &lt; 0.05). The TT-RA distance revealed an OR of 1.35 (95% CI (1.26\u20131.44]), p &lt; 0.001) and an AUC of 0.727 for predicting contralateral LPD. The HKA angle revealed an OR of 1.74 (95% CI (1.51\u20132.00), p &lt; 0.001) and an AUC of 0.797. The Patellar tilt, congruence angle, and patellar displacement had AUC values of 0.703, 0.725, and 0.817 for predicting contralateral LPD, respectively. In conclusion, the contralateral patellofemoral anatomic parameters were significantly different between patients with and without subsequent contralateral LPD. Increased TT-RA distance and excessive valgus deformity were risk factors and could serve as predictors for contralateral LPD. At first-time dislocation, the abnormal position of the patella relative to the trochlea may also be an important cause of subsequent LPD.<\/jats:p>","DOI":"10.3390\/jcm12010180","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T02:55:07Z","timestamp":1672109707000},"page":"180","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prediction of Subsequent Contralateral Patellar Dislocation after First-Time Dislocation Based on Patellofemoral Morphologies"],"prefix":"10.3390","volume":"12","author":[{"given":"Jiaxing","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China"},{"name":"Orthopedic Laboratory, Chongqing Medical University, Chongqing 400016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaochu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China"},{"name":"Orthopedic Laboratory, Chongqing Medical University, Chongqing 400016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sizhu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China"},{"name":"Orthopedic Laboratory, Chongqing Medical University, Chongqing 400016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baoshan","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China"},{"name":"Orthopedic Laboratory, Chongqing Medical University, Chongqing 400016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China"},{"name":"Orthopedic Laboratory, Chongqing Medical University, Chongqing 400016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linbang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7513-997X","authenticated-orcid":false,"given":"Zijie","family":"Xu","sequence":"additional","affiliation":[{"name":"Sports Medicine Department, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China"},{"name":"Orthopedic Laboratory, Chongqing Medical University, Chongqing 400016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengxue","family":"Quan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China"},{"name":"Orthopedic Laboratory, Chongqing Medical University, Chongqing 400016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1717-101X","authenticated-orcid":false,"given":"Aiguo","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China"},{"name":"Orthopedic Laboratory, Chongqing Medical University, Chongqing 400016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1177\/0363546503260788","article-title":"Epidemiology and natural history of acute patellar dislocation","volume":"32","author":"Fithian","year":"2004","journal-title":"Am. J. Sports Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1944","DOI":"10.1007\/s00167-020-06277-x","article-title":"Surgery for patellar dislocation has evolved towards anatomical reconstructions with assessment and treatment of anatomical risk factors","volume":"29","author":"Uimonen","year":"2021","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_3","first-page":"1204","article-title":"High incidence of acute and recurrent patellar dislocations: A retrospective nationwide epidemiological study involving 24.154 primary dislocations","volume":"26","author":"Gravesen","year":"2018","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1177\/0363546517704178","article-title":"Risk Factors and Time to Recurrent Ipsilateral and Contralateral Patellar Dislocations","volume":"45","author":"Christensen","year":"2017","journal-title":"Am. J. Sports Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1055\/s-0037-1604141","article-title":"How Do Axial Scan Orientation Deviations Affect the Measurements of Knee Anatomical Parameters Associated with Patellofemoral Instability? A Simulated Computed Tomography Study","volume":"31","author":"Xiong","year":"2018","journal-title":"J. Knee Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1302\/0301-620X.101B3.BJJ-2018-0795.R2","article-title":"Deepening trochleoplasty and medial patellofemoral ligament reconstruction normalize patellotrochlear congruence in severe trochlear dysplasia","volume":"101-B","author":"Balcarek","year":"2019","journal-title":"Bone Jt. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1007\/s00167-021-06581-0","article-title":"Increased tibial tubercle-trochlear groove and patellar height indicate a higher risk of recurrent patellar dislocation following medial reefing","volume":"30","author":"Ahrend","year":"2022","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2424","DOI":"10.1177\/03635465221102917","article-title":"Changes in Anatomic Risk Factors for Patellar Instability During Skeletal Growth and Maturation","volume":"50","author":"Pruneski","year":"2022","journal-title":"Am. J. Sports Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2342","DOI":"10.1007\/s00167-021-06813-3","article-title":"Patellar dislocation is associated with increased tibial but not femoral rotational asymmetry","volume":"30","author":"Geraghty","year":"2022","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Simonaityt\u0117, R., Rutkauskas, S., \u010cekanauskas, E., Labanauskas, L., and Barauskas, V. (2021). First-Time Acute Lateral Patellar Dislocation in Children and Adolescents: What About Unaffected Knee Patellofemoral Joint Anatomic Abnormalities?. Medicina, 57.","DOI":"10.3390\/medicina57030206"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2709","DOI":"10.1007\/s00167-021-06539-2","article-title":"Ipsilateral patellofemoral morphological abnormalities are more severe than those of contralateral joints in patients with unilateral patellar dislocation","volume":"29","author":"Chen","year":"2021","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1097\/BPO.0000000000000674","article-title":"Predictors of Recurrent Patellar Instability in Children and Adolescents After First-time Dislocation","volume":"37","author":"Jaquith","year":"2017","journal-title":"J. Pediatr. Orthop."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/BF01552649","article-title":"Factors of patellar instability: An anatomic radiographic study","volume":"2","author":"Dejour","year":"1994","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1148\/radiol.14140295","article-title":"Imaging characteristics of contralateral asymptomatic patellofemoral joints in patients with unilateral instability","volume":"273","author":"Demehri","year":"2014","journal-title":"Radiology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1177\/0363546511433028","article-title":"Observer agreement on the Dejour trochlear dysplasia classification: A comparison of true lateral radiographs and axial magnetic resonance images","volume":"40","author":"Lippacher","year":"2012","journal-title":"Am. J. Sports Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1007\/s00167-017-4520-z","article-title":"Quality assessment of radiological measurements of trochlear dysplasia; a literature review","volume":"26","author":"Paiva","year":"2018","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2325967120914872","DOI":"10.1177\/2325967120914872","article-title":"Tibial Tubercle-Roman Arch Distance: A New Measurement of Patellar Dislocation and Indication of Tibial Tubercle Osteotomy","volume":"8","author":"Xu","year":"2020","journal-title":"Orthop. J. Sports Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Chen, J., Yin, B., Yao, J., Zhou, Y., Zhang, H., Zhang, J., and Zhou, A. (2022). Femoral anteversion measured by the surgical transepicondylar axis is a reliable parameter for evaluating femoral rotational deformities in patients with patellar dislocation. Knee Surg. Sports Traumatol. Arthrosc., 1\u20139.","DOI":"10.1007\/s00167-022-07016-0"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"504","DOI":"10.2106\/JBJS.21.00656","article-title":"Tibial Tuberosity-Trochlear Groove Distance and Its Components in Patients with and without Episodic Patellar Dislocation: A Study of 781 Knees","volume":"104","author":"Chen","year":"2022","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"23259671221113841","DOI":"10.1177\/23259671221113841","article-title":"Anatomical Components Associated with Increased Tibial Tuberosity-Trochlear Groove Distance","volume":"10","author":"Xu","year":"2022","journal-title":"Orthop. J. Sports Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/BPB.0000000000000546","article-title":"Simultaneous treatment for patellar instability and genu valgum in skeletally immature patients: A preliminary study","volume":"28","author":"Parikh","year":"2019","journal-title":"J. Pediatr. Orthop. B"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"586","DOI":"10.2106\/JBJS.20.00020","article-title":"Development of a Multivariable Model Based on Individual Risk Factors for Recurrent Lateral Patellar Dislocation","volume":"103","author":"Ling","year":"2021","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1186\/s13018-021-02681-2","article-title":"Association of patellofemoral morphology and alignment with the radiographic severity of patellofemoral osteoarthritis","volume":"16","author":"Dai","year":"2021","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1111\/os.12295","article-title":"Relationship between Patellar Tracking and the \u201cScrew-home\u201d Mechanism of Tibiofemoral Joint","volume":"8","author":"Zhang","year":"2016","journal-title":"Orthop. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1007\/s00167-012-2321-y","article-title":"Evaluation of trochlear dysplasia using MRI: Correlation between the classification system of Dejour and objective parameters of trochlear dysplasia","volume":"22","author":"Nelitz","year":"2014","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2552","DOI":"10.1177\/0363546519888467","article-title":"Factors Associated with an Increased Risk of Recurrence After a First-Time Patellar Dislocation: A Systematic Review and Meta-analysis","volume":"48","author":"Huntington","year":"2020","journal-title":"Am. J. Sports Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s12178-018-9480-5","article-title":"Predicting Risk of Recurrent Patellar Dislocation","volume":"11","author":"Parikh","year":"2018","journal-title":"Curr. Rev. Musculoskelet. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1177\/0363546514554553","article-title":"The effect of tibial tuberosity medialization and lateralization on patellofemoral joint kinematics, contact mechanics, and stability","volume":"43","author":"Stephen","year":"2015","journal-title":"Am. J. Sports Med."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Hinz, M., Cotic, M., Diermeier, T., Imhoff, F.B., Feuerriegel, G.C., Woertler, K., Themessl, A., Imhoff, A.B., and Achtnich, A. (2022). Derotational distal femoral osteotomy for patients with recurrent patellar instability and increased femoral antetorsion improves knee function and adequately treats both torsional and valgus malalignment. Knee Surg. Sports Traumatol. Arthrosc., 1\u20137.","DOI":"10.1007\/s00167-022-07150-9"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.clinbiomech.2017.06.007","article-title":"Increased internal femoral torsion can be regarded as a risk factor for patellar instability\u2014A biomechanical study","volume":"47","author":"Kaiser","year":"2017","journal-title":"Clin. Biomech."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2891","DOI":"10.1007\/s00167-017-4806-1","article-title":"Alignment in the transverse plane, but not sagittal or coronal plane, affects the risk of recurrent patella dislocation","volume":"26","author":"Takagi","year":"2018","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/180\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:51:32Z","timestamp":1760147492000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,26]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["jcm12010180"],"URL":"https:\/\/doi.org\/10.3390\/jcm12010180","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,26]]}}}