Clinical and Functional Outcome After Lateral Trochlear Lengthening Osteotomy Lateral Trochlear Lengthening Osteotomy

NCT04378491 | Completed

• 1 other identifier: 2019-01405; ch20Muendermann2
• Study Type: observational
• Target: 6
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to evaluate the functional and clinical outcome of this new lengthening osteotomy of the lateral trochlea in patients with patella instability, trochlear dysplasia Dejour type A or B, short lateral articular trochlea quantified by the lateral condyle index and presence of a lateral trochlear bump.

Conditions

Patellar Instability

Keywords

lengthening osteotomy of the lateral trochlea; Lateral trochlear lengthening osteotomy; trochlear dysplasia Dejour type A or B; short lateral articular trochlea

Outcome Measures

Primary Outcomes (3)

• presence of a recurrent patellar dislocation/ radiological reduction of the trochlear bump postoperative by plain radiograph of the knee/ lateral view

  presence of a recurrent patellar dislocation postoperative by plain radiograph of the knee/ lateral view: * crossing sign: The sign is positive when the trochlear groove lies in same plane as anterior border of lateral condyle. It represents a flattened trochlear groove * double contour sign: The sign is positive when the anterior border of lateral condyle lies anterior to anterior border of medial condyle. It represents a convex trochlear groove/hypoplastic medial condyle * presence of a lateral trochlear bump prominence * the patellar height will be evaluated according to Insall-Salvati method (normal between 0.8 and 1.2) and Caton Deschamps method (normal between 0.6 and 1.3)

  at Baseline

• presence of a recurrent patellar dislocation/ radiological reduction of the trochlear bump postoperative by Skyline patellar view

  The trochlea form will be assessed, the existence of trochlear dysplasia will be confirmed and classified according to Dejour

  at Baseline

• (Change in) Lateral condyle index assessed by MRI of the knee

  Lateral condyle index assessed by MRI of the knee (preoperative (always conducted) and in the cases where they are available postoperative MRIs). The lateral condyle index was designed to measure the lateral trochlea by comparing the anterior cartilaginous trochlea (a) and the posterior aspect (p) \[(a:p)× 100\].

  at Baseline

Secondary Outcomes (5)

• Subjective Evaluation of the outcome of the operation

  at Baseline

• Kujala Anterior Knee Pain Scale (AKPS)

  at Baseline

• Lysholm Knee Score

  at Baseline

• Visual analog scale score (VAS)

  at Baseline

• Tegner activity scale

  at Baseline

Interventions

Collection of clinical measurements OTHER

Collection of clinical measurements: * Active and passive range of motion (ROM) of the knee, hip and ankle Joint bilaterally. * Passive patellar translation in 30° of flexion billaterally in quadrants of translation. * Patellar apprehension test (Fairbank's Test) and the Moving Patellar Apprehension (MPAT) test for the diagnosis of patellar instability. The Fairbank's Test is performed in 30° of Flexion while the MPAT is performed while flexing the knee from 0° to 90°.

Collection of data for muscle strength OTHER

Collection of data for muscle strength: * Muscle strength will be measured bilaterally using a dynamometer (Biodex System 4 Pro: Biodex Medical Systems, Shirley, NY, USA). For the knee, maximum isokinetic Flexion and extension torques will be collected between full extension and full flexion at a movement speed of 60°/s (3 x 5 repetitions) Maximum joint torques in each movement direction will be recorded for each joint and normalized to body weight

Collection of EMG Data OTHER

Collection of EMG Data: * Surface electrodes will be placed bilaterally on the vastus medialis and lateralis rectus femoris, biceps femoris and semitendinosus muscles following the guidelines of the SENIAM project (Surface ElectroMyoGraphy for the Non-Invasive Assessment of Muscles). Simultaneously with the muscle strength measurements, EMG data will be collected using a 12-channel EMG system (myon AG, Schwarzenberg, Switzerland, sampling rate 2400 Hz).

Collection of Clinical Scores OTHER

Collection of Clinical Scores: * patient's pain, range of motion and ability to perform daily living activities will be assessed using the Kujala Anterior Knee Pain Scale, Lysholm Knee Score, visual analog scale score (VAS) and the Tegner Activity Score

Collection of Imaging Data - Radiological measurements OTHER

Collection of Imaging Data - Radiological measurements: Xrays and MRIs which were already performed as part of the original diagnostic and follow-up procedures pre- and postoperative will be reviewed and analysed.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients treated between 01/2014 and 09/2017 (n=6) with lateral trochlear lengthening osteotomy at the Clinic of Orthopaedics and Traumatology at the University Hospital Basel

You may qualify if:

• years (as of September 2019) since conducting a lateral trochlear lengthening osteotomy

You may not qualify if:

• Inability to provide informed consent
• Neurological disorders potentially affecting lower extremity muscle strength.
• Surgery involving the patellofemoral joint prior to the lateral trochlear lengthening osteotomy

Sponsors & Collaborators

• University Hospital, Basel, Switzerland: lead

Study Sites (1)

Orthopädie/Traumatologie, University Hospital Basel

Basel, 4031, Switzerland

Location

Related Publications (1)

• Ismailidis P, Egloff C, Nuesch C, Mundermann A, Pagenstert G. Lateral trochlear lengthening osteotomy. Arch Orthop Trauma Surg. 2021 Oct;141(10):1721-1730. doi: 10.1007/s00402-020-03736-5. Epub 2021 Feb 24.

  PMID: 33625541 DERIVED

MeSH Terms

Interventions

Muscle Strength

Intervention Hierarchy (Ancestors)

Physical Examination; Diagnostic Techniques and Procedures; Diagnosis; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• +41 (0)61 32 87133 Muendermann, Prof.

  Orthopädie/Traumatologie, University Hospital Basel

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 29, 2020
• First Posted: May 7, 2020
• Study Start: April 1, 2020
• Primary Completion: September 30, 2020
• Study Completion: September 30, 2020
• Last Updated: November 10, 2020

Record last verified: 2020-11

Locations

CH (1)