Ignite Creation Date:
2024-05-06 @ 11:51 AM
Last Modification Date:
2024-10-26 @ 12:51 PM
Study NCT ID:
NCT03615976
Status:
COMPLETED
Last Update Posted:
2021-11-23
First Post:
2018-04-16
Brief Title:
Does Arthroscopic Patellar Denervation With High Tibial Osteotomy Improve Anterior Knee Pain
Sponsor:
Assiut University
Organization:
Assiut University
Study Overview
Official Title:
Does Arthroscopic Patellar Denervation With High Tibial Osteotomy Improve Anterior Knee Pain
Status:
COMPLETED
Status Verified Date:
2021-11
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Arthroscopy will be done in all cases before osteotomy to assess lat Comp and grade of patellofemoral OA Arthroscopic patellar denervation with vaper or diathermy will be done plus open wedge high tibial osteotomy in one group and other group OWHTO only will be done comparing the rustles of two groups to assess the efficacy of this procedure
followed by an average follow up to 12 months And follow up 6th weeks 3rd month 6th month 12th month
By clinical examinationan and x-ray and knee scores
1 Scoring of patellofemoral disorders Kujala score
2 Knee Injury and Osteoarthritis Outcome Score KOOS
followed by an average follow up to 12 months And follow up 6th weeks 3rd month 6th month 12th month
By clinical examinationan and x-ray and knee scores
1 Scoring of patellofemoral disorders Kujala score
2 Knee Injury and Osteoarthritis Outcome Score KOOS
Detailed Description:
Patellofemoral joint osteoarthritis PFOA is a highly prevalent disease and an important source of anterior knee pain and Disability during daily activities kneeling squatting climbing stairs getting up from low chair 35
Coexisting Patellofemoral osteoarthritis PFOA and Tibiofemoral OA disease is a common radiographic pattern of knee OA observed in older adults with knee pain In addition symptomatic disease and reduced function are more likely to be found if radiographic OA changes are present in both the TF and PF compartment also it demonstrates features distinctly different from those observed in Tibiofemoral OA without presence of Patellofemoral osteoarthritis PFOA More specifically ModerateSevere PFOA seems to be associated with lower limb impairments of lower knee extension strength and limitations of knee range of motion 14
146
High tibial osteotomy HTO with medial opening wedge has gained in popularity over recent years and is used for the treatment of medial compartmental osteoarthritis OA but not for anterior knee pain PFOA This procedure is appealing because of the high preservation of the knee joint relative to total knee arthroplasty TKA or unicompartmental knee arthroplasty 9
High tibial osteotomy HTO can cause alterations in patellar height Patella baja and alignment which can increase contact stress and eventually lead to anterior Knee pain 1317
The findings indicate that anterior knee pain might be due to OA progression in the patellofemoral joint after HTO 1112
Patellofemoral OA and Cartilage injuries in PF joints tended to progress after Open Wedge HTO which proven by second lock arthroscopy a significant proportion of patients about 20 had grade II OA of the patellofemoral joint at final follow-Up 2yrs 78
Anterior knee pain also were quite high 28 and 32 in the opening- and closing-wedge groups after surgery Although there are several possible causes for anterior knee pain after HTO such as surgery itself alteration of patellar alignment and OA change in the patellofemoral joint patients with severe anterior knee pain were found to have grade II patellofemoral OA 78
In spite of its high prevalence treatment of this painful disorder PFOA is challenging due to the diversity of causes of the disorder and the lack of knowledge on articular regeneration little information is available in the literature about the best conservative or surgical treatment options35
Non-operative treatment options for patellofemoral osteoarthritis include patellar bracing physical therapy intervention corticosteroid injections patellar taping and strengthening of the quadriceps muscle this is considered a potential short-term fix for many patients Ultimately surgical treatment is necessary to provide a long-term solutions which include Patellofemoral arthroplasty total knee replacement with patellar resurfacing5
Arthroscopic circumpatellar denervation this joint-preserving minimal invasive technique provides relief of anterior knee pain Moreover this technique provide a faster recovery period immediately after surgery and less morbidity 11819 Arthroscopy will be done in all cases before osteotomy to assess lat Comp and grade of patellofemoral OA Arthroscopic patellar denervation with vaper or diathermy will be done plus open wedge high tibial osteotomy in one group and other group OWHTO only will be done comparing the rustles of two groups to assess the efficacy of this procedure
followed by an average follow up to 12 months And follow up 6th weeks 3rd month 6th month 12th month
By clinical examinationan and x-ray and knee scores
1 Scoring of patellofemoral disorders Kujala score
2 Knee Injury and Osteoarthritis Outcome Score KOOS
Coexisting Patellofemoral osteoarthritis PFOA and Tibiofemoral OA disease is a common radiographic pattern of knee OA observed in older adults with knee pain In addition symptomatic disease and reduced function are more likely to be found if radiographic OA changes are present in both the TF and PF compartment also it demonstrates features distinctly different from those observed in Tibiofemoral OA without presence of Patellofemoral osteoarthritis PFOA More specifically ModerateSevere PFOA seems to be associated with lower limb impairments of lower knee extension strength and limitations of knee range of motion 14
146
High tibial osteotomy HTO with medial opening wedge has gained in popularity over recent years and is used for the treatment of medial compartmental osteoarthritis OA but not for anterior knee pain PFOA This procedure is appealing because of the high preservation of the knee joint relative to total knee arthroplasty TKA or unicompartmental knee arthroplasty 9
High tibial osteotomy HTO can cause alterations in patellar height Patella baja and alignment which can increase contact stress and eventually lead to anterior Knee pain 1317
The findings indicate that anterior knee pain might be due to OA progression in the patellofemoral joint after HTO 1112
Patellofemoral OA and Cartilage injuries in PF joints tended to progress after Open Wedge HTO which proven by second lock arthroscopy a significant proportion of patients about 20 had grade II OA of the patellofemoral joint at final follow-Up 2yrs 78
Anterior knee pain also were quite high 28 and 32 in the opening- and closing-wedge groups after surgery Although there are several possible causes for anterior knee pain after HTO such as surgery itself alteration of patellar alignment and OA change in the patellofemoral joint patients with severe anterior knee pain were found to have grade II patellofemoral OA 78
In spite of its high prevalence treatment of this painful disorder PFOA is challenging due to the diversity of causes of the disorder and the lack of knowledge on articular regeneration little information is available in the literature about the best conservative or surgical treatment options35
Non-operative treatment options for patellofemoral osteoarthritis include patellar bracing physical therapy intervention corticosteroid injections patellar taping and strengthening of the quadriceps muscle this is considered a potential short-term fix for many patients Ultimately surgical treatment is necessary to provide a long-term solutions which include Patellofemoral arthroplasty total knee replacement with patellar resurfacing5
Arthroscopic circumpatellar denervation this joint-preserving minimal invasive technique provides relief of anterior knee pain Moreover this technique provide a faster recovery period immediately after surgery and less morbidity 11819 Arthroscopy will be done in all cases before osteotomy to assess lat Comp and grade of patellofemoral OA Arthroscopic patellar denervation with vaper or diathermy will be done plus open wedge high tibial osteotomy in one group and other group OWHTO only will be done comparing the rustles of two groups to assess the efficacy of this procedure
followed by an average follow up to 12 months And follow up 6th weeks 3rd month 6th month 12th month
By clinical examinationan and x-ray and knee scores
1 Scoring of patellofemoral disorders Kujala score
2 Knee Injury and Osteoarthritis Outcome Score KOOS
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None