Patellar Dislocation
Conditions
Keywords
Patellar dislocation, Brace, Knee taping
Brief summary
Study to evaluate the conservative treatment of patients after their first episode of primary lateral patellar dislocation. Randomized controlled trial with 2 groups: standard treatment (2-weeks with brace) followed by physical therapy, compared with knee taping and physical therapy. 1-year follow-up. Measurements include physical exam, radiographs and MRI. Outcomes: recurrence, lateral patellar tilt, functional scores, apprehension, pain. Hypothesis: less recurrence in the knee taping group, as well as better functional scores.
Detailed description
Patients between 10-40 years old with first patellar dislocation are invited to participate in this conservative treatment study. Patients are excluded if they have bilateral acute patellar dislocation, previous surgeries in the affected knee, osteochondral fracture, open patellar dislocation. This is a randomized controlled trial with four groups of treatment: 1. Standard treatment (2-weeks with a knee brace) and physical therapy 2. Knee taping and physical therapy (1-week with knee brace) Sample size: 50 patients / knees Outcomes of interest: recurrence in patellar dislocation, functional scores (Banff, Norwich), return to sport, patellar tilt
Interventions
OTHERStandard care
Bracing and physical therapy
OTHERTaping
The patient is treated with tape in special configuration (McConell modified) for the patella + standard care
DEVICESham taping
Taping with no treatment disposition
Sponsors
International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine
Fundacion Clinica Valle del Lili
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Masking description
The investigator and outcomes assessor will not have access to the type of treatment a patient received.
Intervention model description
Patients are randomized either to standard care or in the intervention group. Standard care patients are treated with knee brace (2 weeks) and physical therapy. In the intervention group: they receive knee taping with knee brace during 1-week.
Eligibility
Sex/Gender
ALL
Age
10 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
\- Patients with first episode of acute lateral patellar dislocation during the last 7 days.
Exclusion criteria
\* Patients with acute bilateral patellar dislocation. * Patients with open patellar dislocation. * Patients with previous knee surgery in the same knee.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recurrent patellar dislocation (percentage of patients) | 2 years | Percentage of patients with additional patellar dislocation after the first episode |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Banff Patellofemoral Instability Instrument (BPII) | 2 years | Patellofemoral instability specific score to assess function (disease-specific). The punctuation range is between 0-100 points. The best health scenario is 100% and the worst is 0. |
| Nich patellar instability (NPI) score | 2 years | Patellofemoral instability specific score to assess function (disease-specific). The punctuation range is between 0-100%. The worst health deficit is 100% and the best is 0%. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Patellar tilt angle of patients after the first episode | 1 month | Patellar tilt in magnetic resonance imaging (angle in degrees) |
| Percentage of participants that return to sport activity | 2 years | Percentage of the patients that were able to return to do their usual sport after the initial injury (patellar dislocation) |
| Patellar apprehension test | 2 years | Patellar apprehension test during physical examination. The quadriceps should be relaxed to allow passive movements of the patella. The clinician will perform this technique by using their thumb of both hands, and pressing on the medial side of the patient's patella. The test is positive if it produces pain and apprehension. |
| Percentage of participants with patellar J sign | 2 years | J sign during physical examination. The J-sign refers to the inverted 'J' track the patella takes from extension to early flexion. The J-sign is a clinical finding indicative of patellar maltracking. |
Countries
Colombia
Contacts
Primary ContactJuan P Martinez, MD
Backup ContactAlejandro Gallego, MD
Outcome results
None listed