Evidence map›Paper›PMID 40837451›Full record

ArticleOrthopaedic journal of sports medicine2025

Variation in Surgical Technique for Medial Patellofemoral Ligament Reconstruction in Skeletally Immature Patients: Data From the JUPITER Prospective Multicenter Study Group.

Benton E Heyworth, Sofia Hidalgo Perea, Daniel W Green, Matthew W Veerkamp, Eric J Wall, Philip L Wilson, Henry B Ellis, Danielle E Chipman, JUPITER Study Group, Beth E Shubin Stein and 13 more

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Article in Orthopaedic journal of sports medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Benton E HeyworthBoston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-2572-1344
Sofia Hidalgo PereaHospital for Special Surgery, New York, New York, USA.
Daniel W GreenHospital for Special Surgery, New York, New York, USA.
Matthew W VeerkampCincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Eric J WallCincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Philip L WilsonScottish Rite for Children, Dallas, Texas, USA.
Henry B EllisScottish Rite for Children, Dallas, Texas, USA.
Danielle E ChipmanHospital for Special Surgery, New York, New York, USA.
JUPITER Study Group
Beth E Shubin SteinHospital for Special Surgery, New York, New York, USA.
Shital N ParikhCincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Jacqueline BradyAll members are listed in the Authors section at the end of this article.
Peter FabricantAll members are listed in the Authors section at the end of this article.
Jack FarrAll members are listed in the Authors section at the end of this article.
Jason KohAll members are listed in the Authors section at the end of this article.
Dennis KramerAll members are listed in the Authors section at the end of this article.
Robert MagnussenAll members are listed in the Authors section at the end of this article.
Matthew MilewskiAll members are listed in the Authors section at the end of this article.
Lauren RedlerAll members are listed in the Authors section at the end of this article.
Sabrina StricklandAll members are listed in the Authors section at the end of this article.
Marc TompkinsAll members are listed in the Authors section at the end of this article.
Adam YankeAll members are listed in the Authors section at the end of this article.
Yi-Meng YenAll members are listed in the Authors section at the end of this article.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Management approaches and surgical techniques for patellofemoral instability (PFI) continue to lack clear clinical guidelines and indications. Medial patellofemoral ligament reconstruction (MPFLR) is the most frequently used surgical procedure; however, variation in technique remains significant, particularly in skeletally immature patients. Purpose/Hypothesis: The purpose of this study was to examine variations in MPFLR technique in skeletally immature patients as represented by 20 orthopaedic surgeons with different experience levels and specialty training backgrounds who perform a high volume of PFI surgery in this age group. The hypothesis was that variation would be high. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Operative records of skeletally immature patients who underwent a primary, single-stage MPFLR between 2016 and 2021 within the JUPITER (JUstifying Patellar Instability Treatment by Results) cohort, a multicenter prospective study involving 13 tertiary care academic centers, were analyzed, including demographic information, injury data, and surgical technique details. Results: Of the 305 surgical PFI cases in skeletally immature patients, 245 knees (46% female, 54% male; mean age, 13.6 ± 1.8 years; range, 5.1-19.0 years) met inclusion criteria. High variation was identified in MPFLR tendon graft type (59% allograft, 41% autograft), patellar fixation (62% suture anchor, 32% patellar bone bridge/tunnel), and femoral fixation (76% interference/tenodesis screw, 23% suture anchor). All cases (100%) used fluoroscopic guidance and physeal-sparing principles, with femoral implant placement distal to the distal femoral physis. High variation was seen in adjunctive procedures, including lateral retinacular release or lengthening (22%), osteochondral fracture treatment (13% overall; 53% of which underwent loose body removal, 44% fixation, and 3% osteochondral allograft implantation), concomitant hemi-epiphysiodesis for genu valgum (9%), and patellar tendon medialization (Grammont procedure, 2%). Conclusion: Despite the presence of open physes, which generally limits PFI surgical technique options, variation in multiple aspects of MPFLR was high among this cohort of 20 high-volume surgeons.

Indexed as

MPFL reconstructionopen physespatellofemoral instabilitypediatricssurgical treatment

Identifiers

PMID40837451
PMCPMC12361740

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.