Does Arthroscopic Patellar Denervation With High Tibial Osteotomy Improve Anterior Knee Pain

NCT03615976 | Completed

• 1 other identifier: arthroscopy in P.F.O.A
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Arthroscopy will be done in all cases before osteotomy to assess lat. Comp and grade of patellofemoral O.A Arthroscopic patellar denervation with vaper or diathermy will be done plus open wedge high tibial osteotomy in one group and other group OWHTO only will be done comparing the rustles of two groups to assess the efficacy of this procedure followed by an average follow up to 12 months. And follow up( 6th weeks ,3rd month ,6th month , 12th month) By clinical examinationan and x-ray and knee scores

1. 1.Scoring of patellofemoral disorders( Kujala) score
2. 2.Knee Injury and Osteoarthritis Outcome Score (KOOS)

Conditions

Anterior Knee Pain Syndrome

Keywords

arthroscopy; Patellofemoral Osteoarthritis

Outcome Measures

Primary Outcomes (1)

• Effect of Arthroscopic patellar denervation after open wedge high tibial osteotomy regarding anterior knee pain

  The aim is to evaluate the effect of arthroscopic denervation of patella In management of anterior Knee pain after High tibial osteotomy operation The effect of denervation was statistically and clinically evaluated using the Knee injury and Osteoarthritis Outcome Score (KOOS) and Kujala (anterior knee pain score) score

  all study 2 years average follow up up to 12 months for all cases

Other Outcomes (2)

• Effect of OWHTO on ant. Knee pain and patellar height

  We will compare the score before and after the surgery and check if it is statically significant. Followed by an average follow up to 12 months ( 6th weeks ,3rd month ,6th month , 12th month)

• Effect of post-operative rehab protocol in Assiut hospital university

  We will compare the score before and after the surgery and check if it is statically significant.followed by an average follow up to 12 months ( 6th weeks ,3rd month ,6th month , 12th month)

Study Arms (2)

group A

ACTIVE COMPARATOR

group A with patellofemoral pain resistant to medical and physiotherapy assessment by pre operative knee score HIGH TIBIAL osteotomy will be done for all patients with arthroscopic patellar denervation will be done

Procedure: high tibial osteotomy with or without arthroscopic circumpatellar denervation with or without arthroscopic circumpatellar denervation

GROUP B

ACTIVE COMPARATOR

operative group B with patellofemoral pain resistant to medical and physiotherapy assessment by pre operative knee score HIGH TIBIAL osteotomy will be done without arthroscopic patellar denervation

Procedure: high tibial osteotomy with or without arthroscopic circumpatellar denervation with or without arthroscopic circumpatellar denervation

Interventions

high tibial osteotomy with or without arthroscopic circumpatellar denervation with or without arthroscopic circumpatellar denervation PROCEDURE

Arthroscopy will be done in all cases before osteotomy to assess lat. Comp and grade of patellofemoral O.A Arthroscopic patellar denervation with vaper or diathermy will be done plus open wedge high tibial osteotomy in one group and other group OWHTO only will be done comparing the rustles of two groups to assess the efficacy of this procedure followed by an average follow up to 12 months. And follow up( 6th weeks ,3rd month ,6th month , 12th month) By clinical examinationan and x-ray and knee scores 1. Scoring of patellofemoral disorders( Kujala) score 2. Knee Injury and Osteoarthritis Outcome Score (KOOS)

Also known as: arthroscopic circumpatellar denervation

GROUP B; group A

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age 30-60.
• Ant. Knee pain PFOA
• Mild to moderate tibiofemoral joint O.A
• Without involvement of lateral compartment
• Range of motion of at least 120° flexion
• BMI less than 30

You may not qualify if:

• Old Age more than 60 and less than 30.
• Advanced cases tibiofemoral O.A which need TKR
• Flextion deformity more than 15 degree
• Varus degree more than 10 degree
• Inflammatory disease, such as rheumatoid arthritis

Sponsors & Collaborators

• Assiut University: lead

Study Sites (1)

Muhammad Kamel

Asyut, Asyut Governorate, Egypt

Location

Related Publications (5)

• Zhao G, Liu Y, Yuan B, Shen X, Qu F, Wang J, Qi W, Zhu J, Liu Y. Arthroscopic patelloplasty and circumpatellar denervation for the treatment of patellofemoral osteoarthritis. Chin Med J (Engl). 2015 Jan 5;128(1):79-84. doi: 10.4103/0366-6999.147820.

  PMID: 25563318 BACKGROUND

• Ferrari MB, Sanchez G, Chahla J, Moatshe G, LaPrade RF. Arthroscopic Patellar Lateral Facetectomy. Arthrosc Tech. 2017 Mar 20;6(2):e357-e362. doi: 10.1016/j.eats.2016.10.002. eCollection 2017 Apr.

  PMID: 28580253 BACKGROUND

• Waryasz GR, McDermott AY. Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors. Dyn Med. 2008 Jun 26;7:9. doi: 10.1186/1476-5918-7-9.

  PMID: 18582383 BACKGROUND

• Witvrouw E, Werner S, Mikkelsen C, Van Tiggelen D, Vanden Berghe L, Cerulli G. Clinical classification of patellofemoral pain syndrome: guidelines for non-operative treatment. Knee Surg Sports Traumatol Arthrosc. 2005 Mar;13(2):122-30. doi: 10.1007/s00167-004-0577-6. Epub 2005 Feb 10.

  PMID: 15703965 BACKGROUND

• Wetzels T, Bellemans J. Patellofemoral osteoarthritis treated by partial lateral facetectomy: results at long-term follow up. Knee. 2012 Aug;19(4):411-5. doi: 10.1016/j.knee.2011.04.005. Epub 2011 May 18.

  PMID: 21596570 BACKGROUND

MeSH Terms

Conditions

Patellofemoral Pain Syndrome

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases

Study Officials

• Hatem Galal Zaki, PROFESSOR

  ASSIUT HOSPITAL UNIVERSITY

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: dr: muhammad kamel muhammad sayed

Model Details: It is prospective case series study The aim is to evaluate the effect of arthroscopic denervation of patella In management of ant. Knee after High tibial osteotomy operation in pain reduction, improving knee joint function, quality of life, and deferring arthritic progression

Study Record Dates

• First Submitted: April 16, 2018
• First Posted: August 6, 2018
• Study Start: March 1, 2017
• Primary Completion: January 1, 2021
• Study Completion: March 1, 2021
• Last Updated: November 23, 2021

Record last verified: 2021-11

Locations

EG (1)