Clinical trial NCT05882591: Posteromedial Tibiofemoral Incongruence (PMTFI) Treatment
Official title: Posteromedial Tibiofemoral Incongruence (PMTFI) Treatment
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Meniscus Disorder
Meniscus; Degeneration
Meniscus Tear
Meniscus Lesion
Lead sponsor: Artromedical Konrad Malinowski Clinic
Sponsor class: OTHER
First posted: 2023-05-31
Enrollment: 10
Sex: ALL
Minimum age (years): 18
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: Single Group Assignment
Primary purpose: TREATMENT

Brief summary: The aim of this study is to assess outcomes of Posteromedial Tibiofemoral Incongruence (PMTFI) Treatment

Detailed description: 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.

Eligibility criteria: 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

Primary outcomes:
measure: Presence of pain in full knee flexion
timeFrame: At the 12 month of the follow-up
measure: Presence of pain in full knee flexion
timeFrame: At the 24 month of the follow-up
Secondary outcomes:
measure: The functional assessment with the The International Knee Documentation Committee Questionnaire (IKDC)
timeFrame: At the 12 month of the follow-up
measure: The functional assessment with the The International Knee Documentation Committee Questionnaire (IKDC)
timeFrame: At the 24 month of the follow-up
measure: The functional assessment with the Knee injury and Osteoarthritis Outcome Score (KOOS)
timeFrame: At the 12 month of the follow-up.
measure: The functional assessment with the Knee injury and Osteoarthritis Outcome Score (KOOS)
timeFrame: At the 24 month of the follow-up.
Other outcomes:
Locations:
city: Bełchatów
country: Poland
facility: Artromedical Orthopaedic Clinic
state: Łódzkie
Study officials:
affiliation: Artromedical Orthopaedic Clinic, Bełchatów, Poland
name: Konrad Malinowski, MD PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Malinowski K, Kozlak M, Mostowy M, LaPrade RF, Ebisz M, Pekala PA. Cam Impingement of the Knee: Arthroscopic Correction of Posteromedial Tibiofemoral Incongruence. Arthrosc Tech. 2022 May 11;11(6):e951-e957. doi: 10.1016/j.eats.2022.01.015. eCollection 2022 Jun.
citation: Suganuma J, Mochizuki R, Yamaguchi K, Inoue Y, Yamabe E, Ueda Y, Fujinaka T. Cam impingement of the posterior femoral condyle in medial meniscal tears. Arthroscopy. 2010 Feb;26(2):173-83. doi: 10.1016/j.arthro.2009.11.002.
citation: Suganuma J. Lack of posteromedial tibiofemoral congruence at full flexion as a causative factor in isolated medial meniscal tears. J Orthop Sci. 2002;7(2):217-25. doi: 10.1007/s007760200036.