Patellar Instability, Patellofemoral Osteoarthritis, Recurrent Patellar Dislocation
Conditions
Keywords
Recurrent Patellar Dislocation, Patellar instability, Isokinetics, Adolescents
Brief summary
Between 2010 and 2012, 33 children and adolescents (39 knees) with recurrent patellar dislocation were treated with MPFL reconstruction using the adductor magnus tendon.The aim of the study is to assess the effectiveness of this surgical procedure in long follow-up. The outcomes will be evaluated functionally (Lysholm knee scale, the Kujala Anterior Knee Pain Scale, and isokinetic examination) and radiographically (Caton-Deschamps index, sulcus angle, congruence angle, and patellofemoral angle). This is a continuation of the research published in 2015 with longer follow-up at least 10 years. All available patients will be evaluated with the same protocol, using the same methods and devices. Functional outcome is planned to be measured with scales as above. In radiological assessment Merchant and lateral knee weight bearing view and additionally MRI will be performed. Isokinetic test will be performed in two speeds of 60 and 180 deg/s. Most of important isokinetic parameters such as peak torque, torque in 30 deg, time to peak torque, peak torque to body weight both for quadriceps and hamstrings will be measured and compared to those from former research. Dedicated statistical test will be used for both: analysis of present status and differences from former results.
Detailed description
Recurrent dislocation of the patella is a common orthopaedic problem which occurs in about 44% of cases after first-time dislocation. In most cases of first-time patellar dislocation, the medial patellofemoral ligament (MPFL) becomes damaged. Between 2010 and 2012, 33 children and adolescents (39 knees) with recurrent patellar dislocation were treated with MPFL reconstruction using the adductor magnus tendon. The aim of the study is to assess the effectiveness of this surgical procedure in long follow-up. The outcomes will be evaluated functionally (Lysholm knee scale, the Kujala Anterior Knee Pain Scale, and isokinetic examination) and radiographically (Caton-Deschamps index, sulcus angle, congruence angle, and patellofemoral angle). This is a continuation of the research published in 2015 with longer follow-up at least 10 years. All available patients will be evaluated with the same protocol, using the same methods and devices. Functional outcome is planned to be measured with scales as above. In radiological assessment Merchant and lateral knee weight bearing view and additionally MRI will be performed. Isokinetic test will be performed in two speeds of 60 and 180 deg/s. Most of important isokinetic parameters such as peak torque, torque in 30 deg, time to peak torque, peak torque to body weight both for quadriceps and hamstrings will be measured and compared to those from former research. Dedicated statistical test will be used for both: analysis of present status and differences from former results.
Interventions
PROCEDUREAdductor magnus tenodesis for recurrent patellar dislocation
In all 33 patients (39 knees) adductor magnus tenodesis was performed to stabilise the patella. Adductor magnus tendon was harvested, cut proximally and fixed to the patella with proper tension.
Sponsors
Polish Mother Memorial Hospital Research Institute
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
15 Years to 27 Years
Healthy volunteers
No
Inclusion criteria
* patellar dislocation that had occurred at least twice, * positive apprehensive test, * completed research protocol * age under 18 years at the time of surgery (adductor magnus tenodesis according to Avikainen)
Exclusion criteria
* first-time patellar dislocation * habitual patellar dislocation * patients with osteochondral fracture
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Apprehension test | up to six months | Fear during patellar passive lateralisation |
| Lysholm Score | up to six months | Subjective outcome evaluation scale |
| Kujala Score | up to six months | Subjective outcome evaluation scale |
| Sulcus angle | up to six months | Index describing trochlear shape |
| Congruence angle | up to six months | Index describing patellar shift |
| Patellofemoral angle | up to six months | Index describing patellar tilt |
| Caton-Deschamps index | up to six months | Index describing patellar height |
| Peak torque | up to six months | Isokinetic evaluation in speeds 60 and 180 degree per second, both for quadriceps and hamstrings, Units of Measure - Newton-Metre (Nm) |
| Torque in 30 deg | up to six months | Isokinetic evaluation in speeds 60 and 180 degree per second, both for quadriceps and hamstrings, Units of Measure - Newton-Metre (Nm) |
| Time to peak torque | up to six months | Isokinetic evaluation in speeds 60 and 180 degree per second, both for quadriceps and hamstrings, Units of Measure - seconds (s) |
| Peak torque to body weight | up to six months | Isokinetic evaluation in speeds 60 and 180 degree per second, both for quadriceps and hamstrings, Units of Measure - Nm/kg |
Countries
Poland
Outcome results
None listed