Late Compared to Early Physiotherapy Following Knee Dislocation
- Conditions
- Traumatic Knee Dislocation
- Interventions
- Other: Early Physiotherapy start
- Registration Number
- NCT01296750
- Lead Sponsor
- Unity Health Toronto
- Brief Summary
A knee dislocation is an unusual and extremely serious injury and is defined as complete displacement of the tibia with respect to the femur, usually with disruption of 3 or more of the stabilizing ligaments. When the knee dislocates, there is often significant damage to the soft-tissues envelope surrounding the joint, including adjacent neurovascular structures. Not surprisingly, this injury is a profoundly debilitating, life-altering event, with the potential to necessitate career change in athletes and laborers alike. Current evidence indicates that operative management for these injuries is more effective at returning patients to pre-morbid range of motion (ROM) and activity than conservative management. Post operative rehabilitation programs for these patients must balance the need for stability of their surgical repair and knee ROM and functionality. Experimental data suggests that post-operative immobilization offers greater protection of the surgical reconstruction, whereas immediate, aggressive physiotherapy may be more effective at preventing arthrofibrosis stiffness. The investigators are proposing a randomized clinical trial comparing early physiotherapy (day one post op) versus immobilization for three weeks then initiation of physiotherapy. The physiotherapy progams will be identicalbe in all aspects except for progam initiation.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 38
- Ambulation without aids in pre-morbid condition
- Multi-ligament knee injury with or without associated peri-articular fracture
- Operative management within three weeks of the injury
- Poly-trauma with life-threatening injuries preventing rehabilitation
- Patients unable to comply with intensive rehabilitation
- Patients unable or unlikely to maintain follow-up
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Early Physiotherapy Early Physiotherapy start Physiotherapy to begin within 1 day post op.
- Primary Outcome Measures
Name Time Method Need for knee manipulation at or within 6months of initial surgery. 6 months Manipulation includes:
1. Knee manipulation under anesthesia
2. Arthroscopic debridement of arthrofibrosis
3. Open debridement of arthrofibrosis
- Secondary Outcome Measures
Name Time Method Knee Range of Motion 6 months Passive Range of Motion
Patient Reported Outcome 6 months Multi-Ligament Quality of Life Questionnaire
Knee stability 6 months Clinical exam of ligament grading
Trial Locations
- Locations (1)
St. Michael's Hospital
🇨🇦Toronto, Ontario, Canada