Canmore

This research aims to evaluate whether repairing the medial patellofemoral ligament MPFL with the help of a Biobrace4 implant can reduce the chance of the kneecap dislocating again after a first-time patellofemoral dislocation. Patellofemoral dislocation is a common knee injury, especially in young people, with recurrence rates varying widely depending on individual risk factors. Current treatments vary, and no clear consensus exists on the best approach to prevent repeat dislocations in patients with mild to moderate risk. Participants will undergo a surgical procedure within 7 days of their first lateral patellofemoral dislocation. This involves knee arthroscopy combined with MPFL repair that is enhanced by a synthetic Biobrace4 ligament designed to support both mechanical strength and biological healing. This intervention is being studied to see if it better maintains the kneecaps position during healing compared to natural outcomes without surgery. During the study, participants will be monitored for up to two years to assess if the patella dislocates again. Assessments include physical tests such as single-leg hop and balance, muscle strength measurements, and patient-reported outcome questionnaires related to knee instability, pain, medication use, and psychological factors. Close follow-up in the initial two weeks will monitor pain and medication use, while longer-term evaluations will focus on knee function and stability.

Researchers are evaluating the role of tibial tubercle osteotomy TTO in improving outcomes after medial patellofemoral ligament reconstruction MPFL-R in patients who have recurrent lateral patellofemoral instability with an increased tibial tubercle-trochlear groove TT-TG distance, with or without patella alta. This pilot randomized clinical trial aims to assess the feasibility of recruitment, adherence to the study protocol, and follow-up completion rates over at least 12 months. The study is conducted by the Banff Sport Medicine Foundation and focuses on patients aged 13 to 30 years. Participants will be randomly assigned to one of two groups isolated MPFL-R or MPFL-R combined with TTO, which can involve medializing, distalizing, or combined adjustments of the patellar tendon insertion. The MPFL-R involves placing a soft tissue graft, either autograft or allograft, to stabilize the patella. The TTO procedure moves the insertion point of the patellar tendon by transferring a bone block to correct the patellas position. Patients will be followed for two years after surgery. During the study, participants will undergo subjective and objective assessments at baseline and at 6, 12, and 24 months post-operation. These include the Banff Patellofemoral Instability Instrument BPII 2.0, functional hop testing, patellar apprehension tests, pain scores, patient satisfaction, and clinical evaluations. Researchers will monitor complications and re-dislocation rates. The primary feasibility outcomes focus on recruitment, protocol adherence, and follow-up completion at 12 months. The study aims to inform a larger trial to optimize treatment for patellofemoral instability.