Dislocation of patella in children Injury, Occupational Diseases, Poisoning Dislocation of patella
Conditions
Interventions
1. The patients will be randomised either to conservative (orthosis) treatment or arthroscopic refixation of the MPFL with the use of anchors
2. The randomisation is made directly after the diagnostic
Sponsors
Capio Research Foundation (Sweden)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Children 9-14 years of age 2. Admitted to the emergency room (ER) with haemartrosis after a traumatic first time patellar dislocation 3. The diagnosis is based on clinical examination, magnetic resonance imaging (MRI) and arthroscopy 4. The arthroscopy is the final confirmation of the diagnosis, and it gives a detailed description of the MPFL injury and possible ostechondral lesions 5. Prior to the arthroscopy, the patients are asked to participate in the study 6. The patients who have given informed consent
Exclusion criteria
Exclusion criteria: 1. Previous significant injury to the same knee including patellar dislocation, systemic joint disease or syndromes affecting the knee joint 2. Osteochondral lesion > 1cm on weight bearing area that needs open reduction and fixation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. The patients are followed continuously 2 years after arthroscopy at our outpatient clinic 2. If they have any problems with their knee during the study period or redislocation they are advised to contact us for help 3. We will do a physical and radiological examination to confirm the diagnosis and the clinical findings will be documented in the medical casebook 4. The primary outcome is redislocation rate of the patella compared between the two groups under these 2 years | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Post-operative complications, knee- examination, joint motion, patient administrated scores to evaluate activity, subjective knee function (Lysholm, Tegner score, KOOS-child and Kujala score) and quality of life for children (EQ-5D-Y) 1.1. Kujala score, which is a 13-item questionnaire with discrete categories related to various levels of knee function. Categories within each item are weighted and responses are summarised to provide an overall index in which 100 represents no disability. Among other things, the questionnaire evaluates pain or disability related to the loading of the patellofemoral joint during sitting, walking, running, jumping, and stair climbing. (Kujala et al. Scoring of patellofemoral disorders. Arthroscopy 1993;9:159-63). Previous authors have also termed the score 'the Anterior Knee Pain Scale (AKPS)'. 1.2. The Lysholm score and Tegner activity scale are commonly used to document outcomes after arthroscopic knee surgery. These outcomes measurements are subjective in nature, and they evaluate performance and activity restrictions both before and after surgery, making them a valuable research tool when judging the effectiveness of surgical treatment. Lysholm score. Am J Sports Med. 2003 Jul-Aug; 31(4):487-92. Tegner activity scale from 0-10 Clin. Orthop. Relat. Res. 1985 Sep; 198(198):43-9. 1.3. Knee Osteoarthritis Outcome score (KOOS) is developed as an instrument to assess the patient?s opinion about knee function and associated problems (the child version is on its way to be validated). 1.4. Health and Quality of Life Outcomes 2003, 1:64. The newly developed EQ-5D-Y is a useful tool to measure health related quality of life in young people in an age appropriate manner. Springerlink.com ; Qual Life Res (2010) 19:875?886 1.5. Objective knee function is measured with hop-tests and ?kneebending/30s-test?. Visual analog scales (VAS) are used to assess activity related pains. The outcome will also be correlated to predisposing factors such | — |
Countries
Sweden
Outcome results
None listed