Clinical Outcomes Following Patellar Dislocation in Young Athletes
Condition: Patella Dislocation Recurrent; Patellar Dislocation
MeSH terms: Joint Dislocations; Patellar Dislocation
Study type: Interventional

Summary: 
      The purpose of this study is to identify predictors of future injury and disability following
      LPD. The investigators' long term goal is to improve longitudinal outcomes of athletes with
      LPD following surgical and non-surgical management. Currently, there is limited information
      available to clinicians regarding appropriate criteria for returning athletes to sports
      participation following LPD. The evidence produced by this study will provide necessary
      information to develop appropriate rehabilitation strategies that may reduce the risk for
      future patellar instability and associated patellofemoral joint dysfunction and pain.
    

Detailed description: 
      The basis of the proposed study is to determine the clinical outcomes following lateral
      patellar dislocation (LPD). Despite surgical and non-surgical interventions, young athletes
      are at high risk for sustaining subsequent dislocations that magnify the effects of
      disability. It is suspected that if athletes return to high-level activities and expose their
      knees to substantial forces without normalized movement strategies, then this may increase
      the risk for future joint injury. Currently, there are no evidence-based criteria to
      determine an athlete's readiness for sports activity following LPD. The purpose of this study
      is to characterize clinical outcomes, function, and neuromuscular control strategies employed
      by athletes following LPD at the time when they are returning to sports participation.

      A prospective, longitudinal study design will be utilized. A cohort of up to 100 athletes
      (ages 12 - 25 years) who have sustained LPD during sports activities that require jumping,
      cutting, or pivoting maneuvers will be consecutively recruited from the offices of local
      orthopaedic surgeons, primary care physicians, and sports physical therapists for this study.
      Investigators will target a subset of surgically managed athletes and a subset of
      non-surgically managed athletes with LPD. A cohort of up to 100 individuals without history
      of knee injury will be recruited from local schools and universities to serve as control
      participants. Data will be collected to evaluate clinical outcomes, thigh and hip strength,
      lower body function, balance and neuromuscular control strategies. Clinical outcomes will be
      assessed using self-report questionnaires and performance-based measures, including hop and
      agility tests. Thigh and hip strength will be assessed utilizing an isokinetic dynamometer.
      Lower body function will be assessed using a series of single-leg and double-leg hopping
      tests. Balance will be assessed utilizing a clinical lower extremity reach test.
      Neuromuscular control will be evaluated by 3-D motion analysis during running, jumping, and
      cutting activities. Overall, this study will provide a comprehensive evaluation of athletes
      following LPD. It will provide important information for the future development of
      rehabilitation approaches that may maximize clinical outcomes for the at risk population.
    

Intervention name(s): biomechanical assessment
Intervention type(s): Other
Intervention description(s): biomechanical and strength assessment of both groups
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Screening