Evaluation of Adductor Magnus Tenodesis in Patients With Recurrent Patellar Dislocation.
Condition: Recurrent Patellar Dislocation; Patellar Instability; Patellofemoral Osteoarthritis
MeSH terms: Joint Dislocations; Patellar Dislocation; Recurrence
Study type: Observational

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.
    

Intervention name(s): Adductor magnus tenodesis for recurrent patellar dislocation
Intervention type(s): Procedure
Intervention description(s): 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.
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Study population consists of 33 patients (39 knees operated) after abductor magnus
        tenodesis for recurrent patellar dislocation with age under 18 at the time of surgery. With
        follow-up at least 10 years, present age of the subjects between 15 and 27 years.
      
Keywords: Recurrent Patellar Dislocation; Patellar instability; Isokinetics; Adolescents