Clinical Results and MRI Evaluation of Patellar Osteochondral Fracture Fixation following Patellar Dislocation

Abstract

Aim. The aim of the study was to analyze the clinical results and MRI scans after transpatellar osteochondral fracture fixation following patellar dislocation. Methods. Our study group comprised 17 patients with patellar dislocation followed by osteochondral fracture of the articular surface of the patella. All patients underwent surgery where the fractured osteochondral fragments of the patella were attached using the transpatellar suture technique. The mean age at the time of surgery was 14.1 years, and the mean follow-up period was 7.5 years. Results. The results of the patellar compression test and the apprehension test were negative in all patients. The mean Lysholm and Kujala scores were 89.2 and 89.6, respectively. The MRI scan revealed healing of the fixed fragment and restoration of the articular surface in all patients. In 16 cases, subchondral bone of the fixed fragment area was described as irregular: its articular cartilage was narrowed and not homogenous. Progressive degenerative changes were observed in the patellofemoral joint at follow-up in three patients. Conclusions. By fixing osteochondral fragments, the patellar articular surface can be restored. The MRI scans show that the cartilage in the reconstructed surface is narrowed after a mean 7.5-year follow-up.

Usefulness of skyline view in the evaluation of acute patellar dislocation: A case study

“…Although it was not because of the abnormality depicted on the SL view that prompted the MR scan, it has relevance in the evaluation of the patella and patellofemoral joint 5,9,11,12 as shown in this case study. There is a paucity of literature about the use of SL view in the evaluation of acute patellofemoral joint injuries.…”

“…Intraarticular haematoma of the knee joint is produced from many injuries including patellar dislocation which oftentimes results in osteochondral fractures in which case a SL view should be included in the trauma radiographic series. 11 In the UK for instance, SL view is not routinely performed as part of the radiographic series in acute knee injuries. Nevertheless, the standard SL view requires a good amount of flexion 6 at the knee and therefore presents as a problem in the injured.…”

Osteochondral Fracture Fixation With Fragment Preserving Suture Technique

“…Other authors have similarly shown that suture fixation restores the surface of articular cartilage but that there may be thinning or narrowing of the cartilage layer on long-term follow-up with their technique that involved suture fixation through the fracture fragment. 17 Histologic investigation of subchondral bone and articular cartilage quality would more precisely characterize healing after treatment of osteochondral fractures with this fragment-sparing technique. Have 3-4 strands of Vicryl suture between each knotless anchor.…”

Treatment of Osteochondral Fractures After Acute Patellofemoral Instability

“…These findings are consistent with a study that analyzed 134 OCFs that were associated with patellofemoral dislocation; Uimonen et al found that 63% of the fractures occurred in the patella, 34% occurred in the lateral femoral condyle, and 3% occurred in both locations 10 . In our analysis of 6 studies that included 171 patients with an OCF after acute patellofemoral instability, we found that 132 (77.2%) sustained a patellar fracture and 39 (22.8%) sustained a femoral fracture (see Appendix) [11][12][13][14][15][16] .…”