Evaluation of Adductor Magnus Tenodesis in Patients With Recurrent Patellar Dislocation.

Study Overview
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Brief Summary
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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
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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.

Official Title
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Clinical, Radiological and Isokinetic Evaluation of Adductor Magnus Tenodesis in Patients With Recurrent Patellar Dislocation.

Conditions
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Recurrent Patellar Dislocation, Patellar Instability, Patellofemoral Osteoarthritis

Intervention / Treatment
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* Procedure: Adductor magnus tenodesis for recurrent patellar dislocation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patellar dislocation that had occurred at least twice, positive apprehensive test, completed research protocol age under 18 years at the time of surgery (adductor magnus tenodesis according to Avikainen) Exclusion Criteria: first-time patellar dislocation habitual patellar dislocation patients with osteochondral fracture

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 27 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Study group after surgery<br>33 children and adolescents (39 knees) with recurrent patellar dislocation were treated with MPFL reconstruction using the adductor magnus tendon between 2010 and 2012. The group is under clinical observation with evaluation being made. | Procedure: Adductor magnus tenodesis for recurrent patellar dislocation<br>* 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.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Apprehension test | Fear during patellar passive lateralisation | up to six months | 
| Lysholm Score | Subjective outcome evaluation scale | up to six months | 
| Kujala Score | Subjective outcome evaluation scale | up to six months | 
| Sulcus angle | Index describing trochlear shape | up to six months | 
| Congruence angle | Index describing patellar shift | up to six months | 
| Patellofemoral angle | Index describing patellar tilt | up to six months | 
| Caton-Deschamps index | Index describing patellar height | up to six months | 
| Peak torque | Isokinetic evaluation in speeds 60 and 180 degree per second, both for quadriceps and hamstrings, Units of Measure - Newton-Metre (Nm) | up to six months | 
| Torque in 30 deg | Isokinetic evaluation in speeds 60 and 180 degree per second, both for quadriceps and hamstrings, Units of Measure - Newton-Metre (Nm) | up to six months | 
| Time to peak torque | Isokinetic evaluation in speeds 60 and 180 degree per second, both for quadriceps and hamstrings, Units of Measure - seconds (s) | up to six months | 
| Peak torque to body weight | Isokinetic evaluation in speeds 60 and 180 degree per second, both for quadriceps and hamstrings, Units of Measure - Nm/kg | up to six months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Recurrent Patellar Dislocation, Patellar instability, Isokinetics, Adolescents