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Anterior Knee Pain and Patellar Tendon Elasticity After Infrapatellar Tendon-Split Tibial Intramedullary Nailing

2026년 8월 24일 업데이트: Bagcilar Training and Research Hospital

Relationship Between Anterior Knee Pain and Patellar Tendon Elasticity After Infrapatellar Tendon-Split Tibial Intramedullary Nailing: A Prospective Cohort Study Using Shear-Wave Ultrasound Elastography

This prospective single-center observational cohort study will evaluate the relationship between anterior knee pain and patellar tendon elasticity after infrapatellar tendon-split tibial intramedullary nailing. Adult patients undergoing standard tibial intramedullary nailing through an infrapatellar tendon-split approach will be enrolled after ethics approval. Patellar tendon elasticity will be assessed using shear-wave ultrasound elastography before surgery and during follow-up at 6 weeks, 3 months, and 6 months. Clinical outcomes will include anterior knee pain severity, patellofemoral function, tendon-related symptoms, and knee range of motion. Inter-rater reliability between two independent radiologists will also be evaluated.

연구 개요

상태

모집하지 않고 적극적으로

정황

개입 / 치료

상세 설명

Anterior knee pain is a frequent complaint after tibial intramedullary nailing, but the role of patellar tendon biomechanical changes remains unclear. The infrapatellar tendon-split approach may lead to tendon healing, remodeling, and fibrosis, which could alter tendon elasticity and contribute to persistent pain and functional limitation. This study aims to prospectively investigate whether changes in patellar tendon elasticity are associated with anterior knee pain after infrapatellar tendon-split tibial intramedullary nailing.

This is a prospective, single-center, non-interventional observational cohort study. Adult patients aged 18 to 65 years with unilateral tibial shaft or metaphyseal fractures treated with standard infrapatellar tendon-split tibial intramedullary nailing will be enrolled consecutively after institutional ethics approval. Only patients enrolled after ethics approval will be included in the registered cohort.

Patellar tendon elasticity will be measured using shear-wave ultrasound elastography at four predefined time points: preoperatively, 6 weeks, 3 months, and 6 months postoperatively. Ultrasound assessments will be performed according to a standardized protocol by two independent radiologists, and inter-rater reliability will be assessed. Additional ultrasound parameters will include tendon thickness on B-mode imaging and Doppler neovascularization.

Clinical outcomes will include anterior knee pain assessed with a visual analog scale, patellofemoral function assessed with the Kujala Anterior Knee Pain Scale, tendon-related symptoms assessed with the VISA-P questionnaire, pressure pain sensitivity, and active knee range of motion. The primary objective is to determine whether change in patellar tendon elasticity is associated with anterior knee pain at 6 months. Secondary objectives are to examine associations between tendon elasticity and functional scores, range of motion, tendon thickness, Doppler findings, and inter-rater measurement reliability.

연구 유형

관찰

등록 (추정된)

50

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • Istanbul
      • Istanbul, Istanbul, 터키 (Türkiye), 34320
        • Bagcilar Training and Research Hospital

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인
  • 고령자

건강한 자원 봉사자를 받아들입니다

아니

샘플링 방법

비확률 샘플

연구 인구

Adults with unilateral tibial shaft or metaphyseal fractures treated at Bagcilar Training and Research Hospital with standard infrapatellar tendon-split tibial intramedullary nailing will be enrolled prospectively after ethics approval.

설명

Inclusion Criteria:

  • Age 18 to 65 years
  • Unilateral tibial shaft or metaphyseal fracture
  • Planned treatment with infrapatellar tendon-split tibial intramedullary nailing
  • Ability to complete baseline and follow-up assessments
  • Written informed consent

Exclusion Criteria:

  • Previous surgery on the same knee
  • Previous patellar tendon rupture or known patellar tendon disorder
  • Active inflammatory rheumatologic disease
  • Chronic systemic corticosteroid therapy or long-term immunosuppressive treatment
  • Significant peripheral neuropathy or advanced diabetic neuropathy
  • Bilateral tibial fracture
  • Additional major lower-extremity injury or surgery affecting assessment
  • Inability to comply with scheduled follow-up visits

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

코호트 및 개입

그룹/코호트
개입 / 치료
Infrapatellar Tendon-Split Tibial Nailing Cohort
Adult patients with unilateral tibial shaft or metaphyseal fractures treated with standard infrapatellar tendon-split tibial intramedullary nailing after ethics approval. Participants will be followed prospectively with shear-wave ultrasound elastography and clinical assessments at baseline, 6 weeks, 3 months, and 6 months.
Standard-of-care tibial intramedullary nailing performed through an infrapatellar longitudinal patellar tendon split approach. The procedure is not assigned by the protocol; only patients undergoing this routine surgical approach are observed.
Non-invasive shear-wave ultrasound elastography of the patellar tendon performed at predefined study visits using a standardized imaging protocol.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Change in patellar tendon elasticity from baseline to 6 months
기간: Preoperative baseline and 6 months postoperatively
Patellar tendon elasticity measured by shear-wave ultrasound elastography in kilopascals. The primary analysis will assess the longitudinal change from baseline to 6 months.
Preoperative baseline and 6 months postoperatively

2차 결과 측정

결과 측정
측정값 설명
기간
Change in patellar tendon elasticity from baseline to 3 months
기간: Preoperative baseline and 3 months postoperatively
Change in patellar tendon elasticity measured by shear-wave ultrasound elastography.
Preoperative baseline and 3 months postoperatively
Anterior knee pain severity
기간: Baseline and postoperative 6 weeks, 3 months, and 6 months
Anterior knee pain severity will be assessed using the Visual Analog Scale. The Visual Analog Scale ranges from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate worse anterior knee pain.
Baseline and postoperative 6 weeks, 3 months, and 6 months
Patellofemoral function
기간: Preoperative baseline, 3 months, and 6 months
Patellofemoral function will be assessed using the Kujala Anterior Knee Pain Scale. The scale ranges from 0 to 100 points, with higher scores indicating better patellofemoral function and fewer anterior knee symptoms.
Preoperative baseline, 3 months, and 6 months
Patellar Tendon-Related Symptoms and Function
기간: Preoperative baseline, 3 months, and 6 months
Patellar tendon-related symptoms and function will be assessed using the Victorian Institute of Sport Assessment-Patella questionnaire. The questionnaire ranges from 0 to 100 points, with higher scores indicating fewer patellar tendon-related symptoms and better function
Preoperative baseline, 3 months, and 6 months
Active knee range of motion
기간: Preoperative baseline, 6 weeks, 3 months, and 6 months
Active knee flexion and extension lag measured with a goniometer.
Preoperative baseline, 6 weeks, 3 months, and 6 months
Patellar tendon thickness
기간: Preoperative baseline, 6 weeks, 3 months, and 6 months
Patellar tendon thickness measured on B-mode ultrasound.
Preoperative baseline, 6 weeks, 3 months, and 6 months
Doppler neovascularization
기간: Preoperative baseline, 6 weeks, 3 months, and 6 months
Semiquantitative Doppler neovascularization score.
Preoperative baseline, 6 weeks, 3 months, and 6 months
Pressure Pain Sensitivity
기간: 6 weeks, 3 months, and 6 months
Pressure pain sensitivity will be assessed by recording pain intensity during a standardized pressure pain assessment using the Visual Analog Scale. The Visual Analog Scale ranges from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate greater pressure pain sensitivity.
6 weeks, 3 months, and 6 months
Inter-rater reliability of shear-wave elastography measurements
기간: Baseline, 6 weeks, 3 months, and 6 months
Agreement between two independent radiologists assessed using intraclass correlation coefficients.
Baseline, 6 weeks, 3 months, and 6 months

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2025년 12월 5일

기본 완료 (추정된)

2026년 11월 30일

연구 완료 (추정된)

2026년 12월 31일

연구 등록 날짜

최초 제출

2026년 6월 15일

QC 기준을 충족하는 최초 제출

2026년 6월 17일

처음 게시됨 (실제)

2026년 6월 22일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 8월 26일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 8월 24일

마지막으로 확인됨

2026년 8월 1일

추가 정보

이 연구와 관련된 용어

기타 연구 ID 번호

  • BEA-ORT-MYY-01

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

아니요

IPD 계획 설명

Individual participant data will not be shared because this is a single-center study with a limited sample size and no predefined external data-sharing agreement. Only aggregate, de-identified study results will be reported in publications and presentations.

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미국 FDA 규제 기기 제품 연구

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .