Posteromedial Tibiofemoral Incongruence (PMTFI) Treatment

Study Overview
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Brief Summary
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The aim of this study is to assess outcomes of Posteromedial Tibiofemoral Incongruence (PMTFI) Treatment

Detailed Description
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The aim of this study is to assess outcomes of Posteromedial Tibiofemoral Incongruence (PMTFI) Treatment by the means of published technique (reference nr 1). A decrease in the posterior curvature of the femoral metaphysis close to the medial femoral condyle is one of the anatomical alterations that can be seen within the knee joint. When the knee is fully flexed, this curve is typically concave enough to accommodate the posterior horn of the medial meniscus (PHMM). Similar to cam incongruence in the hip joint, a decrease in curvature may cause posteromedial tibiofemoral incongruence, a condition marked by compression of the PHMM in complete knee flexion. If deep knee flexion occurs, clinical symptoms may appear, and PHMM degeneration may be shown to worsen over time. Surgery may be recommended for patients for whom activity modification and conservative therapy have failed. Our team proposed an arthroscopic procedure that allows for the least amount of correction that is still necessary while also providing final intraoperative confirmation of the clinical need to repair posteromedial tibiofemoral incongruence.

Official Title
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Posteromedial Tibiofemoral Incongruence (PMTFI) Treatment

Conditions
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Meniscus Disorder, Meniscus; Degeneration, Meniscus Tear, Meniscus Lesion

Intervention / Treatment
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* Procedure: Posteromedial Tibiofemoral Incongruence (PMTFI) Treatment by the means of published technique (reference nr 1).


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pain, snapping or discomfort in posterior part of the knee in deep knee flexion during squat Reduced concavity of the femoral metaphysis proximal to the medial femoral condyle confirmed on MRI Impingement of posterior horn of medial meniscus with the metaphysis of femur during full knee flexion confirmed arthroscopically Exclusion Criteria: Active knee inflammation Chondral injuries ICRS 3-4 Extraarticular reasons of pain, snapping or discomfort in posterior part of the knee in deep knee flexion during squat Cyst or avascular changes within the femoral metaphysis adjacent to the planned localization of the procedure

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 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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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Main arm of the study<br>Posteromedial Tibiofemoral Incongruence (PMTFI) Treatment by the means of published technique (reference nr 1). | Procedure: Posteromedial Tibiofemoral Incongruence (PMTFI) Treatment by the means of published technique (reference nr 1).<br>* Posteromedial Tibiofemoral Incongruence (PMTFI) Treatment by the means of published technique (reference nr 1).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Presence of pain in full knee flexion | Presence of pain in full knee flexion - deep squat: pain yes/no | At the 12 month of the follow-up | 
| Presence of pain in full knee flexion | Presence of pain in full knee flexion - deep squat: pain yes/no | At the 24 month of the follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The functional assessment with the The International Knee Documentation Committee Questionnaire (IKDC) | Min of 0 max of 87 points, higher scores mean a better outcome | At the 12 month of the follow-up | 
| The functional assessment with the The International Knee Documentation Committee Questionnaire (IKDC) | Min of 0 max of 87 points, higher scores mean a better outcome | At the 24 month of the follow-up | 
| The functional assessment with the Knee injury and Osteoarthritis Outcome Score (KOOS) | Min of 0 max of 100 points, higher scores mean a better outcome | At the 12 month of the follow-up. | 
| The functional assessment with the Knee injury and Osteoarthritis Outcome Score (KOOS) | Min of 0 max of 100 points, higher scores mean a better outcome | At the 24 month of the follow-up. |