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Contact Information:

Mrs Manjit Aujla
+44 24 765 74996
REPPORT@warwick.ac.uk


More information about this study, what is involved and how to take part can be found on the study website.

Study Location:

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Be Part of Research - Trial Details - Physiotherapy or surgery for repeat kneecap dislocation: a randomised controlled trial

Physiotherapy or surgery for repeat kneecap dislocation: a randomised controlled trial

Medical Conditions

Recurrent patellar dislocation


This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.


A kneecap (patellar) dislocation, where the kneecap comes out to the side of the knee, is very painful. It is a common problem for people in their teens and early twenties. After the first dislocation, the weakened muscles and structures around the knee can allow this to happen again. People often feel that the kneecap is going to dislocate and change their activities to prevent it coming out. This combination of repeated dislocations, and the feeling that it is going to happen, is unpleasant, painful, and stops people getting on with their normal lives (education, work and social activity). We do not know the best way to treat this problem. Some specialists believe that without surgery, dislocations and restriction will continue. Others believe that physiotherapy works well and avoids the risks and cost of surgery. We will offer and compare two different treatments to people who have repeated kneecap dislocation; personalised knee therapy, which includes physiotherapy and individual care and advice to prevent dislocation, or surgery which tightens structures around the knee to prevent dislocation.

Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.  

The recruitment start and end dates are as follows:

01 Jul 2023 31 Aug 2025

Publications

2024 Protocol article in https://pubmed.ncbi.nlm.nih.gov/39174058/ (added 23/08/2024)

Participants will be provided information about the trial and given the opportunity to ask questions before providing informed consent. Participants will then be randomly assigned to receive either personalised knee therapy, which includes physiotherapy and individual care and advice to prevent dislocation, or surgery, which tightens structures around the knee to prevent dislocation. We will collect health and medical information from these participants before they are randomly assigned to each treatment options, as well as 6, 12, 18 and 24 months after


A kneecap (patellar) dislocation, where the kneecap comes out to the side of the knee, is very painful. It is a common problem for people in their teens and early twenties. After the first dislocation, the weakened muscles and structures around the knee can allow this to happen again. People often feel that the kneecap is going to dislocate and change their activities to prevent it coming out. This combination of repeated dislocations, and the feeling that it is going to happen, is unpleasant, painful, and stops people getting on with their normal lives (education, work and social activity). We do not know the best way to treat this problem. Some specialists believe that without surgery, dislocations and restriction will continue. Others believe that physiotherapy works well and avoids the risks and cost of surgery. We will offer and compare two different treatments to people who have repeated kneecap dislocation; personalised knee therapy, which includes physiotherapy and individual care and advice to prevent dislocation, or surgery which tightens structures around the knee to prevent dislocation.
Who can participate?
Individuals will be eligible for the trial if they are aged 16 years and over and have experienced at least two (self-reported) lateral patellar dislocations affecting the same knee.

You can take part if:



You may not be able to take part if:


Current participant exclusion criteria as of 18/06/2024: 1. Open growth plates on standard care imaging (typically but not restricted to MRI). Surgery in the skeletally immature requires different surgical techniques and is beyond the scope of this trial.2. Presence of another knee condition which may cause instability (e.g., cruciate ligament instability, unstable meniscal tear)3. Previous patellofemoral surgery, except simple arthroscopy with/without lateral release4. Severe trochlea dysplasia which in the opinion of the treating clinician requires trochleoplasty.*5. Malalignment of femur or tibia requiring corrective osteotomy (not including tibial tubercle osteotomy).*6. Osteochondral/chondral injury requiring surgery, except removal of loose body.7. Medial patellar dislocation or dislocations when the knee flexes (i.e., the patella is located in extension and dislocates every time the knee flexes).8. Previous randomisation into the trial (i.e., the other knee).9. Unable to have either physiotherapy or surgery.10. Unable to adhere to trial protocols or completion of questionnaires (the need to offer translations will be kept under review by the trial team).* These are uncommon, <10% of the population, and challenging to treat.





Previous participant exclusion criteria: 1. Open growth plates on standard care imaging (typically but not restricted to MRI). Surgery in the skeletally immature requires different surgical techniques and is beyond the scope of this trial2. Presence of another knee condition which may cause instability (e.g., cruciate ligament instability, unstable meniscal tear)3. Previous patellofemoral surgery, except simple arthroscopy with/without lateral release4. Severe trochlea dysplasia requiring trochleoplasty* 5. Malalignment of femur or tibia requiring corrective osteotomy (not including tibial tubercle osteotomy)* 6. Osteochondral/chondral injury requiring surgery7. Medial patellar dislocation8. Previous randomisation into the trial (i.e., the other knee)9. Unable to adhere to trial protocols or completion of questionnaires (the need to offer translations will be kept under review by the trial team)*These are uncommon, <10% of the population, and are challenging to treat


Below are the locations for where you can take part in the trial. Please note that not all sites may be open.

  • NHS Lothian
    Waverley Gate 2-4 Waterloo Place
    Edinburgh
    EH1 3EG
  • Southmead Hospital
    Southmead Road Westbury-on-trym
    Bristol
    BS10 5NB
  • Belfast Health and Social Care Trust
    Trust Headquarters A Floor - Belfast City Hospital Lisburn Road
    Belfast
    BT9 7AB
  • Cardiff & Vale University Lhb
    Woodland House Maes-y-coed Road
    Cardiff
    CF14 4HH
  • Manchester University NHS Foundation Trust
    Cobbett House Oxford Road
    Manchester
    M13 9WL
  • University Hospitals of Leicester NHS Trust
    Leicester Royal Infirmary Infirmary Square
    Leicester
    LE1 5WW
  • Ninewells Hospital
    Ninewells Avenue
    Dundee
    DD1 9SY
  • Norfolk and Norwich University Hospitals NHS Foundation Trust
    Colney Lane Colney
    Norwich
    NR4 7UY
  • Royal Gwent Hospital
    Cardiff Road
    Newport
    NP20 2UB
  • University Hospitals Bristol and Weston NHS Foundation Trust
    Trust Headquarters Marlborough Street
    Bristol
    BS1 3NU
  • St James's University Hospital
    Beckett Street
    Leeds
    LS9 7TF
  • Walsgrave General Hospital
    Clifford Bridge Road
    Coventry
    CV2 2DX
  • James Cook University Hospital
    Marton Road
    Middlesbrough
    TS4 3BW
  • William Harvey Hospital
    Kennington Road Willesborough
    Ashford
    TN24 0LZ
  • Royal Preston Hospital
    Sharoe Green Lane North Fulwood
    Preston
    PR2 9HT
  • Milton Keynes University Hospital NHS Foundation Trust
    Standing Way Eaglestone
    Milton Keynes
    MK6 5LD
  • Queen Margaret Hospital
    Whitefield Road
    Dunfermline
    KY12 0SU
  • Queen Elizabeth Hospital Birmingham
    University Hospitals Birmingham NHS Foundation Trust Mindelsohn Way
    Birmingham
    B15 2TH
  • North Tyneside Health Care NHS Trust
    North Tyneside General Hospital Rake Lane
    North Shields
    NE29 8NH
  • Stepping Hill Hospital
    Poplar Grove
    Stockport
    SK2 7JE
  • Royal Devon University Healthcare NHS Foundation Trust
    Royal Devon University NHS Ft Barrack Road
    Exeter
    EX2 5DW
  • Dewi Sant Hospital
    Albert Road
    Pontypridd
    CF37 1LB
  • St Cadocs Hospital
    Lodge Road Caerleon
    Newport
    NP18 3XQ
  • St Georges Hospital (wandle Annexe)
    St. Georges Hospital Blackshaw Road Tooting
    London
    SW17 0QT
  • Lewisham and Greenwich NHS Trust
    University Hospital Lewisham Lewisham High Street
    London
    SE13 6LH
  • Calderdale and Huddersfield NHS Foundation Trust
    Trust Headquarters Acre Street Lindley
    Huddersfield
    HD3 3EA
  • Ipswich Hospital
    Heath Road
    Ipswich
    IP4 5PD
  • Southampton
    Southampton General Hospital Tremona Road
    Southampton
    SO16 6YD
  • Cumberland Infirmary
    Newtown Road
    Carlisle
    CA2 7HY
  • Queen Alexandra Hospital
    Southwick Hill Road Cosham
    Portsmouth
    PO6 3LY
  • Bolton Royal Hospital
    Minerva Road Farnworth
    Bolton
    BL4 0JR
  • Torbay Hospital
    Newton Road
    Torquay
    TQ2 7AA
  • Colchester General Hospital
    Colchester District General Hosp. Charter Way Turner Road
    Colchester
    CO4 5JL
  • Western Health and Social Care Trust
    Mdec Building Altnagelvin Area Hospital Site Glenshane Road
    Londonderry
    BT47 6SB
  • New Cross Hospital Royal Wolverhampton
    Wolverhampton Road Heath Town
    Wolverhampton
    WV10 0QP
  • University Hospital Monklands
    NHS Lanarkshire, Monkscourt Ave
    Airdrie
    ML6 0JS
  • Musgrove Park Hospital
    Somerset Foundation Trust, Parkfield Dr
    Taunton
    TA1 5DA
  • Broomfield University Hospital
    Broomfield Hospital Court Road
    Chelmsford
    CM1 7ET
  • Queen Elizabeth the Queen Mothers Hospital
    East Kent Hospitals University NHS Foundation Trust, Ramsgate Rd
    Margate
    CT9 4AN

There are no additional risks over and above what the surgeon/treating clinicians would normally inform people about. The requirement to undergo surgical consent or consent for treatment remains in place following normal site specific NHS policies and procedures. The risks with surgery include persistent knee pain, infection and blood clots, but these are the same risks for patients that do not take part in the study who undergo surgery. The risks of PKT are minimal but include post-intervention pain, muscle soreness, or tiredness. The risk associated with PKT are also the same for patients that do not take part in the study but have routine physiotherapy.

Mrs Manjit Aujla
+44 24 765 74996
REPPORT@warwick.ac.uk



More information about this study, what is involved and how to take part can be found on the study website.


The study is sponsored by University of Warwick and funded by NIHR Evaluation, Trials and Studies Co-ordinating Centre (NETSCC); Grant Codes: NIHR134398.




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Read full details for Trial ID: ISRCTN17972668

Or CPMS 55618

Last updated 25 March 2025

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