{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:10:24Z","timestamp":1785427824231,"version":"3.56.0"},"reference-count":55,"publisher":"Open Medical Publishing","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Medial patellofemoral ligament reconstruction is a widely used surgical technique to address patellar instability. This procedure is influenced by several key factors, including patient-specific factors, anatomical considerations, graft selection, tunnel placement, tensioning, fixation methods, postoperative rehabilitation, and potential complications. Various graft options, including autografts and allografts, have been studied, with research indicating no significant differences in pain reduction, return to activity, or failure rates between the two. However, some studies suggest allografts may have a lower failure rate and recurrence of patellar instability compared to autografts. The precise placement of the femoral tunnel is essential for successful reconstruction. Ensuring that the graft is neither too tight nor too loose during fixation contributes significantly to the biomechanical stability of the knee. Different fixation methods, including suture anchors and interference screws, have been compared, with both providing reliable initial fixation strength. Postoperative rehabilitation is another crucial aspect, with studies showing that accelerated protocols can yield favorable outcomes without increasing the risk of recurrent instability. Complications such as recurrent dislocations, patellar fractures, and infections have been reported, with technical errors during surgery being a major contributing factor. A comprehensive approach, involving precise surgical technique and tailored rehabilitation protocols, is necessary to minimize complications and optimize long-term success.<\/jats:p>","DOI":"10.52965\/001c.138208","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T22:01:39Z","timestamp":1747951299000},"source":"Crossref","is-referenced-by-count":3,"title":["A Landscape of Recent Literature on the Predictors of Success and Failure in Medial Patellofemoral Ligament Reconstruction"],"prefix":"10.52965","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0493-5325","authenticated-orcid":true,"given":"Yasser","family":"Alshomrani","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01xjqrm90","id-type":"ROR","asserted-by":"publisher"}],"name":"Umm al-Qura University","department":["Department of Orthopedics"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"30777","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"issue":"4","key":"ref1","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1007\/s00167-017-4505-y","article-title":"High rate of recurrent patellar dislocation in skeletally immature patients: a long-term population-based study","volume":"26","author":"T. L. Sanders","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"14","key":"ref2","doi-asserted-by":"publisher","first-page":"3385","DOI":"10.1177\/0363546518803936","article-title":"Risk of redislocation after primary patellar dislocation: a clinical prediction model based on magnetic resonance imaging variables","volume":"46","author":"E. A. Arendt","year":"2018","journal-title":"Am J Sports Med"},{"issue":"1","key":"ref3","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1007\/s00167-018-5062-8","article-title":"Incidence of second-time lateral patellar dislocation is associated with anatomic factors, age, and injury patterns of medial patellofemoral ligament in first-time lateral patellar dislocation: a prospective magnetic resonance imaging study with 5-year follow-up","volume":"27","author":"G. Zhang","year":"2019","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"7","key":"ref4","doi-asserted-by":"publisher","first-page":"1638","DOI":"10.1177\/0363546519841371","article-title":"Age at time of surgery but not sex is related to outcomes after medial patellofemoral ligament reconstruction","volume":"47","author":"L. A. Hiemstra","year":"2019","journal-title":"Am J Sports Med"},{"issue":"11","key":"ref5","doi-asserted-by":"publisher","first-page":"3751","DOI":"10.1007\/s00167-022-06986-5","article-title":"Age, body mass index, female gender, and patellofemoral cartilage degeneration predict worse patient outcome after patellofemoral instability surgery","volume":"30","author":"N. \u017dlak","year":"2022","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"3","key":"ref6","doi-asserted-by":"publisher","first-page":"674","DOI":"10.52312\/jdrs.2024.1518","article-title":"Anatomical medial patellofemoral ligament reconstruction improves sport participation and activity levels in adolescents with recurrent patellar dislocation","volume":"35","author":"\u00c7. \u00d6rs","year":"2024","journal-title":"Jt Dis Relat Surg"},{"issue":"8","key":"ref7","doi-asserted-by":"publisher","first-page":"3381","DOI":"10.1007\/s00167-023-07391-2","article-title":"Functional outcomes after medial patellofemoral ligament reconstruction show inverted J-shaped relation with body mass index","volume":"31","author":"N. Sharma","year":"2023","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"1","key":"ref8","doi-asserted-by":"publisher","first-page":"e257","DOI":"10.1016\/j.asmr.2022.11.023","article-title":"Medial patellofemoral ligament reconstruction in obese patients results in low complication rates and improved subjective outcomes","volume":"5","author":"S. L. Sherman","year":"2023","journal-title":"Arthrosc Sports Med Rehabil"},{"issue":"10","key":"ref9","doi-asserted-by":"publisher","first-page":"23259671241270358","DOI":"10.1177\/23259671241270358","article-title":"Comparison of clinical and radiological outcomes with body mass index after medial patellofemoral ligament reconstruction","volume":"12","author":"H. Zhan","year":"2024","journal-title":"Orthop J Sports Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"198","DOI":"10.2174\/1874325001509010198","article-title":"Medial patellofemoral ligament reconstruction: A longitudinal study comparison of 2 techniques with 2- and 5-years follow-up","volume":"9","author":"D. C. Astur","year":"2015","journal-title":"Open Orthop J"},{"issue":"5","key":"ref11","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1177\/0363546503260788","article-title":"Epidemiology and natural history of acute patellar dislocation","volume":"32","author":"D. C. Fithian","year":"2004","journal-title":"Am J Sports Med"},{"issue":"2","key":"ref12","doi-asserted-by":"publisher","first-page":"e661","DOI":"10.1016\/j.asmr.2021.12.009","article-title":"The minimal clinically important difference, substantial clinical benefit, and patient-acceptable symptomatic state after medial patellofemoral ligament reconstruction","volume":"4","author":"J. M. Walsh","year":"2022","journal-title":"Arthrosc Sports Med Rehabil"},{"issue":"12","key":"ref13","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.1302\/0301-620X.94B12.29562","article-title":"Medial patellofemoral ligament reconstruction for patellar instability in patients with hypermobility: a case-control study","volume":"94","author":"N. R. Howells","year":"2012","journal-title":"J Bone Joint Surg Br"},{"issue":"11","key":"ref14","doi-asserted-by":"publisher","first-page":"3834","DOI":"10.1007\/s00167-021-06440-y","article-title":"Patients unable to return to play following medial patellofemoral ligament reconstructions demonstrate poor psychological readiness","volume":"29","author":"E. T. Hurley","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"12","key":"ref15","doi-asserted-by":"publisher","first-page":"2325967118812363","DOI":"10.1177\/2325967118812363","article-title":"Mental health has no predictive association with self-assessed knee outcome scores in patients after osteochondral allograft transplantation of the knee","volume":"6","author":"J. Ackermann","year":"2018","journal-title":"Orthop J Sports Med"},{"issue":"5","key":"ref16","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.jisako.2023.08.001","article-title":"Patella alta and increased TT-TG distance do not adversely affect patient-reported outcomes following isolated MPFL reconstruction: a systematic review","volume":"8","author":"N. Pappa","year":"2023","journal-title":"J ISAKOS"},{"issue":"1","key":"ref17","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.csm.2021.07.002","article-title":"Patella alta: when to correct and impact on other anatomic risk factors for patellofemoral instability","volume":"41","author":"R. M. Biedert","year":"2022","journal-title":"Clin Sports Med"},{"issue":"11","key":"ref18","doi-asserted-by":"publisher","first-page":"1563","DOI":"10.1007\/s00402-018-2971-4","article-title":"Does patella alta lead to worse clinical outcome in patients who undergo isolated medial patellofemoral ligament reconstruction? A systematic review","volume":"138","author":"A. Bartsch","year":"2018","journal-title":"Arch Orthop Trauma Surg"},{"issue":"4","key":"ref19","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1177\/0363546520902132","article-title":"How does isolated medial patellofemoral ligament reconstruction influence patellar height?","volume":"48","author":"F. Luceri","year":"2020","journal-title":"Am J Sports Med"},{"issue":"6","key":"ref20","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1177\/0363546519838405","article-title":"Clinical outcomes and predictive factors for failure with isolated MPFL reconstruction for recurrent patellar instability: a series of 211 reconstructions with a minimum follow-up of 3 years","volume":"47","author":"E. Sappey-Marinier","year":"2019","journal-title":"Am J Sports Med"},{"issue":"7","key":"ref21","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1055\/s-0035-1564730","article-title":"Indications for medial patellofemoral ligament reconstruction: a systematic review","volume":"29","author":"M. Yeung","year":"2016","journal-title":"J Knee Surg"},{"issue":"1","key":"ref22","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/BF01552649","article-title":"Factors of patellar instability: an anatomic radiographic study","volume":"2","author":"H. Dejour","year":"1994","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"4","key":"ref23","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1177\/0363546517745625","article-title":"Clinical outcomes after isolated medial patellofemoral ligament reconstruction for patellar instability among patients with trochlear dysplasia","volume":"46","author":"J. N. Liu","year":"2018","journal-title":"Am J Sports Med"},{"issue":"6","key":"ref24","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1177\/0363546516635626","article-title":"Effect of trochlear dysplasia on outcomes after isolated soft tissue stabilization for patellar instability","volume":"44","author":"L. A. Hiemstra","year":"2016","journal-title":"Am J Sports Med"},{"issue":"3","key":"ref25","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1177\/0363546513518413","article-title":"Does degree of trochlear dysplasia and position of femoral tunnel influence outcome after medial patellofemoral ligament reconstruction?","volume":"42","author":"G. P. Hopper","year":"2014","journal-title":"Am J Sports Med"},{"issue":"11","key":"ref26","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1007\/s00167-019-05469-4","article-title":"Recurrent patellar dislocations: trochleoplasty improves the results of medial patellofemoral ligament surgery only in severe trochlear dysplasia","volume":"27","author":"S. Zaffagnini","year":"2019","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"5","key":"ref27","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1007\/s00113-012-2197-9","article-title":"Chronische patellofemorale Instabilit\u00e4t [Chronic patellofemoral instability]","volume":"115","author":"W. Petersen","year":"2012","journal-title":"Der Unfallchirurg"},{"issue":"6","key":"ref28","doi-asserted-by":"publisher","first-page":"416","DOI":"10.3944\/aott.2012.2883","article-title":"Is there any relationship between Q-angle and lower extremity malalignment?","volume":"46","author":"D. Kaya","year":"2012","journal-title":"Acta Orthop Traumatol Turc"},{"issue":"1","key":"ref29","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s13018-020-01713-2","article-title":"Valgus malalignment causes increased forces on a medial collateral ligament reconstruction under dynamic valgus loading: A biomechanical study","volume":"15","author":"C. Peez","year":"2020","journal-title":"J Orthop Surg Res"},{"issue":"3","key":"ref30","doi-asserted-by":"publisher","first-page":"e913","DOI":"10.1016\/j.eats.2021.01.006","article-title":"Implant-mediated guided growth for coronal plane angular deformity in the pediatric patient with patellofemoral instability","volume":"10","author":"K. M., et al. Lin","year":"2021","journal-title":"Arthroscopy Techniques"},{"issue":"7","key":"ref31","doi-asserted-by":"publisher","first-page":"23259671241256983","DOI":"10.1177\/23259671241256983","article-title":"Comparison of clinical outcomes after medial patellofemoral ligament reconstruction with allograft versus autograft: A matched-cohort analysis","volume":"12","author":"J. Henstenburg","year":"2024","journal-title":"Orthop J Sports Med"},{"issue":"4","key":"ref32","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1177\/2325967121S00296","article-title":"Outcomes following medial patellofemoral ligament reconstruction with allograft: A systematic review","volume":"81","author":"C. A. Colasanti","year":"2023","journal-title":"Bull Hosp Jt Dis"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.knee.2021.01.001","article-title":"Isolated medial patellofemoral ligament reconstruction outcomes: a systematic review and meta-analysis","volume":"44","author":"C. Castagno","year":"2021","journal-title":"Knee"},{"issue":"10","key":"ref34","doi-asserted-by":"publisher","first-page":"23259671211046639","DOI":"10.1177\/23259671211046639","article-title":"Autograft versus allograft for medial patellofemoral ligament reconstruction: A systematic review","volume":"9","author":"G. M. Aliberti","year":"2021","journal-title":"Orthop J Sports Med"},{"issue":"4","key":"ref35","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1016\/j.arthro.2017.11.027","article-title":"Graft choice in isolated medial patellofemoral ligament reconstruction: A systematic review with meta-analysis of rates of recurrent instability and patient-reported outcomes for autograft, allograft, and synthetic options","volume":"34","author":"R. J. McNeilan","year":"2018","journal-title":"Arthroscopy"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.knee.2022.05.011","article-title":"Clinical outcomes of medial patellofemoral ligament reconstruction using FiberTape and knotless SwiveLock anchors","volume":"37","author":"E. Sasaki","year":"2022","journal-title":"Knee"},{"issue":"5","key":"ref37","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1007\/s00402-007-0300-4","article-title":"Technical note: anatomical reconstruction of the medial patellofemoral ligament using a free gracilis autograft","volume":"128","author":"P. B. Schottle","year":"2008","journal-title":"Arch Orthop Trauma Surg"},{"issue":"4","key":"ref38","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.1007\/s00167-021-06603-x","article-title":"Femoral tunnel malposition is the most common indication for revision medial patellofemoral ligament reconstruction with promising early outcomes following revision reconstruction: A systematic review","volume":"30","author":"M. Walker","year":"2022","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"6","key":"ref39","doi-asserted-by":"publisher","first-page":"23259671241241537","DOI":"10.1177\/23259671241241537","article-title":"Biomechanical properties and kinematics of medial patellofemoral ligament reconstruction: A systematic review","volume":"12","author":"J. M. Walsh","year":"2024","journal-title":"Orthop J Sports Med"},{"issue":"2","key":"ref40","doi-asserted-by":"publisher","first-page":"2325967116687749","DOI":"10.1177\/2325967116687749","article-title":"Medial patellofemoral ligament reconstruction femoral tunnel accuracy: Relationship to disease-specific quality of life","volume":"5","author":"L. A. Hiemstra","year":"2017","journal-title":"Orthop J Sports Med"},{"issue":"3","key":"ref41","doi-asserted-by":"publisher","first-page":"175","DOI":"10.5435\/JAAOS-22-03-175","article-title":"Guidelines for medial patellofemoral ligament reconstruction in chronic lateral patellar instability","volume":"22","author":"V. Sanchis-Alfonso","year":"2014","journal-title":"J Am Acad Orthop Surg"},{"issue":"11","key":"ref42","doi-asserted-by":"publisher","first-page":"23259671241294011","DOI":"10.1177\/23259671241294011","article-title":"All-suture anchor onlay fixation for medial patellofemoral ligament reconstruction: A biomechanical comparison of fixation constructs","volume":"12","author":"B. L. Smith","year":"2024","journal-title":"Orthop J Sports Med"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1016\/j.knee.2021.08.006","article-title":"Accelerated rehabilitation program following medial patellofemoral ligament reconstruction does not increase risk of recurrent instability","volume":"38","author":"R. A. Magnussen","year":"2022","journal-title":"Knee"},{"issue":"8","key":"ref44","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.3390\/jpm13081240","article-title":"Clinical Insights into the Treatment of Patellofemoral Instability with Medial Patellofemoral Ligament Reconstruction: Pearls and Pitfalls-Lessons Learned from 20 Years","volume":"13","author":"K. Papp","year":"2023","journal-title":"J Pers Med"},{"issue":"1","key":"ref45","doi-asserted-by":"publisher","first-page":"e133","DOI":"10.1016\/j.asmr.2021.09.030","article-title":"Rehabilitation and return to sport after medial patellofemoral complex reconstruction","volume":"4","author":"R. E. Lampros","year":"2022","journal-title":"Arthrosc Sports Med Rehabil"},{"issue":"1","key":"ref46","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1177\/0363546521990004","article-title":"Return to sport after medial patellofemoral ligament reconstruction: A systematic review and meta-analysis","volume":"50","author":"B. N. Platt","year":"2022","journal-title":"Am J Sports Med"},{"issue":"5","key":"ref47","doi-asserted-by":"publisher","first-page":"1345","DOI":"10.1016\/j.arthro.2023.01.098","article-title":"Complication rates after medial patellofemoral ligament reconstruction range from 0% to 32% with 0% to 11% recurrent instability: A systematic review","volume":"39","author":"G. R. Jackson","year":"2023","journal-title":"Arthroscopy"},{"issue":"12","key":"ref48","doi-asserted-by":"publisher","first-page":"e87","DOI":"10.2106\/JBJS.K.01449","article-title":"Complications of medial patellofemoral ligament reconstruction: Common technical errors and factors for success: AAOS exhibit selection","volume":"94","author":"M. J. Tanaka","year":"2012","journal-title":"J Bone Joint Surg Am"},{"issue":"9","key":"ref49","doi-asserted-by":"publisher","first-page":"1478","DOI":"10.1177\/0363546506287486","article-title":"Technical errors during medial patellofemoral ligament reconstruction could overload medial patellofemoral cartilage: a computational analysis","volume":"34","author":"J. J. Elias","year":"2006","journal-title":"Am J Sports Med"},{"issue":"11","key":"ref50","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.1007\/s00167-010-1147-8","article-title":"Hamstring graft fixation in MPFL reconstruction at the patella using a transosseous suture technique","volume":"18","author":"R. Siebold","year":"2010","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"16","key":"ref51","doi-asserted-by":"publisher","first-page":"279","DOI":"10.3238\/arztebl.2020.0279","article-title":"Conservative versus surgical treatment for primary patellar dislocation","volume":"117","author":"J. Frings","year":"2020","journal-title":"Dtsch Arztebl Int"},{"issue":"10","key":"ref52","doi-asserted-by":"publisher","first-page":"2438","DOI":"10.1007\/s00167-014-2919-3","article-title":"Clinical outcomes of medial patellofemoral ligament reconstruction in patients with an increased tibial tuberosity-trochlear groove distance","volume":"22","author":"T. Matsushita","year":"2014","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"6","key":"ref53","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1177\/0363546519835800","article-title":"Isolated medial patellofemoral ligament reconstruction for patellar instability regardless of tibial tubercle-trochlear groove distance and patellar height: outcomes at 1 and 2 years","volume":"47","author":"B. J. Erickson","year":"2019","journal-title":"Am J Sports Med"},{"issue":"12","key":"ref54","doi-asserted-by":"publisher","first-page":"23259671231195905","DOI":"10.1177\/23259671231195905","article-title":"Does tibial tuberosity osteotomy improve outcomes when combined with medial patellofemoral ligament reconstruction in the presence of increased tibial tuberosity-trochlear groove distance? A systematic review and meta-analysis","volume":"11","author":"B. Guevel","year":"2023","journal-title":"Orthop J Sports Med"},{"issue":"12","key":"ref55","doi-asserted-by":"publisher","first-page":"232596711877427","DOI":"10.1177\/2325967118774272","article-title":"Adolescent medial patellofemoral ligament reconstruction: A comparison of the use of autograft versus allograft hamstring","volume":"6","author":"N. Kumar","year":"2018","journal-title":"Orthop J Sports Med"}],"container-title":["Orthopedic Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/orthopedicreviews.openmedicalpublishing.org\/article\/138208-a-landscape-of-recent-literature-on-the-predictors-of-success-and-failure-in-medial-patellofemoral-ligament-reconstruction","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T01:00:02Z","timestamp":1761440402000},"score":1,"resource":{"primary":{"URL":"https:\/\/orthopedicreviews.openmedicalpublishing.org\/article\/138208-a-landscape-of-recent-literature-on-the-predictors-of-success-and-failure-in-medial-patellofemoral-ligament-reconstruction"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,23]]},"references-count":55,"URL":"https:\/\/doi.org\/10.52965\/001c.138208","relation":{},"ISSN":["2035-8164"],"issn-type":[{"value":"2035-8164","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,23]]}}}