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The purpose of this study is to evaluate the functional and clinical outcome of this new lengthening osteotomy of the lateral trochlea in patients with patella instability, trochlear dysplasia Dejour type A or B, short lateral articular trochlea quantified by the lateral condyle index and presence of a lateral trochlear bump.
A short lateral articular trochlea leads to failure in stabilizing the patella close to full Extension of the knee. To address this type of pathology, a trochlear lengthening osteotomy was described. To date only case reports describing the clinical outcome of this new osteotomy exist and information on functional outcome regarding muscle strength and electromyography (EMG) data is lacking. The purpose of this study is to evaluate the functional and clinical outcome of this new lengthening osteotomy of the lateral trochlea in patients with patella instability, trochlear dysplasia Dejour type A or B, short lateral articular trochlea quantified by the lateral condyle index and presence of a lateral trochlear bump.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Collection of clinical measurements | Other | Collection of clinical measurements:
| ||
| Collection of data for muscle strength | Other | Collection of data for muscle strength:
| ||
| Collection of EMG Data | Other | Collection of EMG Data:
|
| Measure | Description | Time Frame |
|---|---|---|
| presence of a recurrent patellar dislocation/ radiological reduction of the trochlear bump postoperative by plain radiograph of the knee/ lateral view | presence of a recurrent patellar dislocation postoperative by plain radiograph of the knee/ lateral view:
| at Baseline |
| presence of a recurrent patellar dislocation/ radiological reduction of the trochlear bump postoperative by Skyline patellar view | The trochlea form will be assessed, the existence of trochlear dysplasia will be confirmed and classified according to Dejour | at Baseline |
| (Change in) Lateral condyle index assessed by MRI of the knee | Lateral condyle index assessed by MRI of the knee (preoperative (always conducted) and in the cases where they are available postoperative MRIs). The lateral condyle index was designed to measure the lateral trochlea by comparing the anterior cartilaginous trochlea (a) and the posterior aspect (p) [(a:p)× 100]. | at Baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Subjective Evaluation of the outcome of the operation | The patients will be asked to subjectively evaluate the outcome of the operation according to the following options:
|
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Inclusion Criteria:
Exclusion Criteria:
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All patients treated between 01/2014 and 09/2017 (n=6) with lateral trochlear lengthening osteotomy at the Clinic of Orthopaedics and Traumatology at the University Hospital Basel
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| Name | Affiliation | Role |
|---|---|---|
| +41 (0)61 32 87133 Muendermann, Prof. | Orthopädie/Traumatologie, University Hospital Basel | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Orthopädie/Traumatologie, University Hospital Basel | Basel | 4031 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33625541 | Derived | Ismailidis P, Egloff C, Nuesch C, Mundermann A, Pagenstert G. Lateral trochlear lengthening osteotomy. Arch Orthop Trauma Surg. 2021 Oct;141(10):1721-1730. doi: 10.1007/s00402-020-03736-5. Epub 2021 Feb 24. |
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| Collection of Clinical Scores | Other | Collection of Clinical Scores:
|
| Collection of Imaging Data - Radiological measurements | Other | Collection of Imaging Data - Radiological measurements: Xrays and MRIs which were already performed as part of the original diagnostic and follow-up procedures pre- and postoperative will be reviewed and analysed. |
| at Baseline |
| Kujala Anterior Knee Pain Scale (AKPS) | The Kujala AKPS is a 13-item screening instrument designed to assess patellofemoral pain in adolescents and young adults, with a variable ordinal response format. For example, a 'Limp' score would be scored as follows: none (5), slight/periodic (3), constant (0). Total scores range from 0 to 100. | at Baseline |
| Lysholm Knee Score | The Lysholm Knee Score consists of eight items that measure: pain (25 points), instability (25 points), locking (15 points), swelling (10 points), limp (5 points), stair climbing (10 points), squatting (5 points), and need for support (5 points). Every question response has been assigned an arbitrary score on an increasing scale. The total score is the sum of each response to the eight questions, and may range from 0-100. Higher scores indicate a better outcome with fewer symptoms or disability. | at Baseline |
| Visual analog scale score (VAS) | The visual analogue scale (VAS) is a 100-mm horizontal line on which the patient's pain intensity is represented by a point between the extremes of "no pain at all" and "worst pain imaginable. | at Baseline |
| Tegner activity scale | The Tegner activity scale is a one-item score that graded activity based on work and sports activities on a scale of 0 to 10. Zero represents disability because of knee problems and 10 represents national or international level soccer. | at Baseline |
| ID | Term |
|---|---|
| D053580 | Muscle Strength |
| ID | Term |
|---|---|
| D010808 | Physical Examination |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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