Patellar Dislocation, Patellar Instability
Conditions
Keywords
Torsion of tibial tuberosity, Recurrent patellar dislocation, MRI Measurements, Patellar instability, Patellar dislocation, Tibial tubercle position, Tibial tubercle torsion
Brief summary
Patellar instability (recurrent patellar dislocation) can occur at any age. It is most often seen in young subjects, especially among adolescents. It is commonly accompanied by anatomical factors. A new factor not described in bibliographic sources and characterized by an external torsion of the tibial tuberosity is frequently found in patients with patellar instability thanks to MRIs. This does not seem to be the case when there is no patellar pathology. A statistical study is needed to assess this rotary anomaly. Validate the predictive benefits when measuring the torsion of tibial tuberosity in cases with recurrent patellar dislocation.
Detailed description
Patellar instability (recurrent patellar dislocation) can occur at any age. It is most often seen in young subjects, especially among adolescents. It is commonly accompanied by anatomical factors known to be driving: Dysplasia of the trochlea, patella alta, lateralisation of the tibial tuberosity, patellar torsion and misalignment, tearing of the Medial Patello Femoral Ligament... The assessment of these factors is essential to evaluate the instability and guide the procedures of the surgical treatment. MRIs have become an important test for the analysis and measurement of these factors. A new factor not described in bibliographic sources and characterized by an external torsion of the tibial tuberosity is frequently found in patients with patellar instability thanks to MRIs. This does not seem to be the case when there is no patellar pathology. A statistical study is needed to assess this rotary anomaly. It will be necessary to take it into account in the future regarding indications and techniques for tibial tuberosity osteotomies, often used to correct patellar instability.
Interventions
None listed
Sponsors
Dr Vincent Chassaing
European Clinical Trial Experts Network
Ramsay Générale de Santé
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Men or women * Subjects who have not expressed opposition to the use of the data for research purposes Clinical criteria: * Unstable group: * Medical history with 2 patellar dislocations or more, * with or without requiring surgical treatment after an MRI Control group: Men or women over 18 years old * Subjects who have not expressed opposition to the use of the data for research purposes * Control group: * Patients showing meniscal injury on MRI who may or may not have been treated (meniscectomy or stitches)
Exclusion criteria
* Unstable group: * MRI performed on one knee operated for patellar instability * Associated tearing of the ligament (ACL, PCL) * Control group: * Patients with a medical history of patellar pathology * Patients with associated ligament injury (ACL, PCL)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Existence of Tibial Tuberosity Torsion. | 4 reviewers Assessment of 92 IRM of patients. Study data collection from April 2010 until december 2016. Patient duration follow up not applicable. | This criteria will be considered relevant if it is associated with patellar dislocation. Existence Yes or No and measure of the torsion in degre on the IRM |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Measure of Patellar Tilt | 4 reviewers Assessment of 92 IRM of patients. Study data collection from April 2010 until december 2016. Patient duration follow up not applicable. Unit in degre | Patellar Tilt (yes or no), based on a patient IRM. Unit in degre. |
| Distance TT-TG Tibial Tuberosity and Trochlear Groove | 4 reviewers Assessment of 92 IRM of patients. Study data collection from April 2010 until december 2016. Patient duration follow up not applicable. | distance between Tibial Tuberosity and Trochlear Groove |
Countries
France
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Patellar Instability Group Group of patients with patellar instability stemming from a recurrent patellar dislocation | 37 |
| Control Group Control Group that has not been checked for patellar instability. | 55 |
| Total | 92 |
Baseline characteristics
| Characteristic | Control Group Control | Total | Patellar Instability Group |
|---|---|---|---|
| Age, Categorical <=18 years | 1 Participants | 2 Participants | 1 Participants |
| Age, Categorical >=65 years | 1 Participants | 1 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 53 Participants | 89 Participants | 36 Participants |
| Age, Continuous mean | 46 years STANDARD_DEVIATION 14 | 39 years STANDARD_DEVIATION 15.4 | 28.6 years STANDARD_DEVIATION 10.7 |
| Race and Ethnicity Not Collected | — | 0 Participants | — |
| Region of Enrollment France | 55 participants | 92 participants | 37 participants |
| Sex: Female, Male Female | 19 Participants | 42 Participants | 23 Participants |
| Sex: Female, Male Male | 36 Participants | 50 Participants | 14 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Existence of Tibial Tuberosity Torsion.
This criteria will be considered relevant if it is associated with patellar dislocation. Existence Yes or No and measure of the torsion in degre on the IRM
Time frame: 4 reviewers Assessment of 92 IRM of patients. Study data collection from April 2010 until december 2016. Patient duration follow up not applicable.
Population: Analysis based on the IRM available
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Patellar Instability Group | Existence of Tibial Tuberosity Torsion. | 17.5 degre |
| Control Group Control | Existence of Tibial Tuberosity Torsion. | 5.3 degre |
Secondary
Distance TT-TG Tibial Tuberosity and Trochlear Groove
distance between Tibial Tuberosity and Trochlear Groove
Time frame: 4 reviewers Assessment of 92 IRM of patients. Study data collection from April 2010 until december 2016. Patient duration follow up not applicable.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Patellar Instability Group | Distance TT-TG Tibial Tuberosity and Trochlear Groove | 17 milimeters |
| Control Group Control | Distance TT-TG Tibial Tuberosity and Trochlear Groove | 8.4 milimeters |
Secondary
Measure of Patellar Tilt
Patellar Tilt (yes or no), based on a patient IRM. Unit in degre.
Time frame: 4 reviewers Assessment of 92 IRM of patients. Study data collection from April 2010 until december 2016. Patient duration follow up not applicable. Unit in degre
Population: Patients with IRM available.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Patellar Instability Group | Measure of Patellar Tilt | 19.8 degre |
| Control Group Control | Measure of Patellar Tilt | 5.3 degre |