Late Compared to Early Physiotherapy Following Knee Dislocation (Co_Leap)

Unity Health Toronto

Status: Completed

Conditions: Traumatic Knee Dislocation

Treatments: Other: Early Physiotherapy start

Study type: Interventional

Funder types: Other

Identifiers

NCT01296750

SMH Co_LEAP

Details and patient eligibility

About

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.

Enrollment: 38 patients

Sex: All

Ages: 18 to 100 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 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

Exclusion criteria

• Poly-trauma with life-threatening injuries preventing rehabilitation
• Patients unable to comply with intensive rehabilitation
• Patients unable or unlikely to maintain follow-up

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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38 participants in 2 patient groups

Early Physiotherapy

Active Comparator group

Description:

Physiotherapy to begin within 1 day post op.

Treatment:

Other: Early Physiotherapy start

Late Physiotherapy

No Intervention group

Description:

Physiotherapy to start 6 weeks post op