Torsion of the Tibial Tuberosity, a New Factor of Patellar Instability?

NCT ID: NCT03304119

Last Updated: 2019-03-20

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 92 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2016-04-01
• Study Completion Date: 2016-12-30

Brief Summary

Patellar instability (recurrent patellar dislocation) can occur at any age. It is most often seen in young subjects, especially among adolescents. It is commonly accompanied by anatomical factors. A new factor not described in bibliographic sources and characterized by an external torsion of the tibial tuberosity is frequently found in patients with patellar instability thanks to MRIs. This does not seem to be the case when there is no patellar pathology. A statistical study is needed to assess this rotary anomaly. Validate the predictive benefits when measuring the torsion of tibial tuberosity in cases with recurrent patellar dislocation.

Detailed Description

Patellar instability (recurrent patellar dislocation) can occur at any age. It is most often seen in young subjects, especially among adolescents. It is commonly accompanied by anatomical factors known to be driving: Dysplasia of the trochlea, patella alta, lateralisation of the tibial tuberosity, patellar torsion and misalignment, tearing of the Medial Patello Femoral Ligament... The assessment of these factors is essential to evaluate the instability and guide the procedures of the surgical treatment. MRIs have become an important test for the analysis and measurement of these factors. A new factor not described in bibliographic sources and characterized by an external torsion of the tibial tuberosity is frequently found in patients with patellar instability thanks to MRIs. This does not seem to be the case when there is no patellar pathology. A statistical study is needed to assess this rotary anomaly. It will be necessary to take it into account in the future regarding indications and techniques for tibial tuberosity osteotomies, often used to correct patellar instability.

Conditions

Patellar Instability; Patellar Dislocation

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Patellar instability group

Group of patients with patellar instability stemming from a recurrent patellar dislocation

No interventions assigned to this group

Control group control

Group that has not been checked for patellar instability.

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

• Men or women
• Subjects who have not expressed opposition to the use of the data for research purposes

Clinical criteria:

• Unstable group:

• Medical history with 2 patellar dislocations or more,
• with or without requiring surgical treatment after an MRI Control group: Men or women over 18 years old
• Subjects who have not expressed opposition to the use of the data for research purposes
• Control group:

• Patients showing meniscal injury on MRI who may or may not have been treated (meniscectomy or stitches)

Exclusion Criteria

• Unstable group:

• MRI performed on one knee operated for patellar instability
• Associated tearing of the ligament (ACL, PCL)
• Control group:

• Patients with a medical history of patellar pathology
• Patients with associated ligament injury (ACL, PCL)

• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Dr Vincent Chassaing

UNKNOWN

Sponsor Role: collaborator

European Clinical Trial Experts Network

OTHER

Sponsor Role: collaborator

Ramsay Générale de Santé

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

ECTEN

Paris, IDF, France

Countries

France

References

Skelley N, Friedman M, McGinnis M, Smith C, Hillen T, Matava M. Inter- and intraobserver reliability in the MRI measurement of the tibial tubercle-trochlear groove distance and trochlea dysplasia. Am J Sports Med. 2015 Apr;43(4):873-8. doi: 10.1177/0363546514565768. Epub 2015 Jan 28.

Reference Type: BACKGROUND

PMID: 25632054 (View on PubMed)

The Patellofemoral Joint - State of the Art in Evaluation and Management. ISAKOS 2014. Alberto Gobbi, Joao Espregueira-Mendes, Norima Nakamura Editors

Reference Type: BACKGROUND

Diederichs G, Issever AS, Scheffler S. MR imaging of patellar instability: injury patterns and assessment of risk factors. Radiographics. 2010 Jul-Aug;30(4):961-81. doi: 10.1148/rg.304095755.

Reference Type: BACKGROUND

PMID: 20631363 (View on PubMed)

Biedert RM. [Osteotomies]. Orthopade. 2008 Sep;37(9):872, 874-6, 878-80 passim. doi: 10.1007/s00132-008-1294-5. German.

Reference Type: BACKGROUND

PMID: 18682913 (View on PubMed)

Pache T, Meystre JL, Delgado-Martins H, Schnyder P. [Transplantation of the anterior tibial tubercle by the Elmslie-Trillat technic. Indications as a function of morphotype]. Rev Chir Orthop Reparatrice Appar Mot. 1985;71(6):359-64. French.

Reference Type: BACKGROUND

PMID: 4081137 (View on PubMed)

Rhee SJ, Pavlou G, Oakley J, Barlow D, Haddad F. Modern management of patellar instability. Int Orthop. 2012 Dec;36(12):2447-56. doi: 10.1007/s00264-012-1669-4. Epub 2012 Oct 7.

Reference Type: BACKGROUND

PMID: 23052278 (View on PubMed)

Guilbert S, Chassaing V, Radier C, Hulet C, Remy F, Chouteau J, Chotel F, Boisrenoult P, Sebilo A, Ferrua P, Ehkirch FP, Bertin D, Dejour D; French Arthroscopy Society (SFA). Axial MRI index of patellar engagement: a new method to assess patellar instability. Orthop Traumatol Surg Res. 2013 Dec;99(8 Suppl):S399-405. doi: 10.1016/j.otsr.2013.10.006. Epub 2013 Nov 20.

Reference Type: BACKGROUND

PMID: 24268843 (View on PubMed)

Other Identifiers

RGDS TTA study

Identifier Type: -

Identifier Source: org_study_id