Su P, Liu X, Jian N, et al. - The clinical outcomes of medial patellofemoral ligament (MPFL) reconstruction combined with tibial tubercle osteotomy (TTO) and lateral retinacular release (LRR) at least 3 years after operation are described and potential risk factors for recurrent patellar instability are investigated. Performing a retrospective analysis of medical records for patients treated with MPFL, TTO and LRR from 2013 to 2017, researchers identified a total of 108 knees in 98 patients for inclusion in this study; mean age at operation: 19.2 ± 6.1 years (range, 13–40 years). Per outcomes, MPFL combined with TTO and LRR seems to be a reliable surgical method, with a low failure rate (5.6%). Worse postoperative outcomes were more frequently observed in correlation with female gender. In this study, following were preoperative failure risk factors: age and trochlear dysplasia.