& Seo, YJ. This small sample size was inevitable because of delicate inclusion criteria. These five cases were not included in the final outcome analysis because surgery was performed during follow-up period. 2008;40(4):606–11. In addition, final functional knee scores significantly improved from the base line in both groups. author EditorInformation 2004;27(10):1058–62. Rorabeck CH, Bobechko WP. Arbortext Advanced Print Publisher 9.1.440/W Unicode 5,6 However, the quality and quantity of the resultant developing tissue is unpredictable with either option. ICD-10-CM Code for Osteochondral fracture of patella S82.01 ICD-10 code S82.01 for Osteochondral fracture of patella is a medical classification as listed by WHO under the range - Injury, poisoning and certain other consequences of external causes . A large tendon, called the quadriceps tendon, covers the patella and connects the thigh muscles to the lower leg bone. Management of first-time patellar dislocations. Text name XMP Paged-Text OCD usually causes pain during and after sports. The second most common cause of hemarthrosis to the knee, after ACL injury, is patellar dislocation with an incidence of osteochondral fracture in approximately 70% of patients [23-25] (Fig. J Bone Joint Surg Am. The aim of the study was to analyze the clinical results and MRI scans after transpatellar osteochondral fracture fixation following patellar dislocation. The study was approved by IRB (institutional review board)/EC (Ethics committee) of Dongtan Sacred Heart Hospital, Hallym University, Korea (approval number: HDT 2019–06-016). They reported no statistical difference between the medial structure repair group and non-repair group in terms of IKDC scores. The common identifier for all versions and renditions of a document. Bag EditorInformation volume 21, Article number: 617 (2020) Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. converted Bag SeriesEditorInformation In terms of redislocation rate, it was 31.2% for group 1 and 26.6% for group 2, showing no significant difference between the two groups (p = 0.690). They represent 1% of all fractures [2]. Specifies the types of author information: name and ORCID of an author. Correspondence to Initial conservative treatment of osteochondral fracture of the patella following first-time patellar dislocation Si Young Song, Tae-Soung Kim and Young-Jin Seo* Abstract Background: There has been no gold standard of the initial treatment strategy for acute patellar dislocation (APD) with osteochondral fracture … Geary M, Schepsis A. AuthorInformation Google Scholar. Surgical treatment. However, all five patients with large OCF involving the central ridge of the patella failed non-operative treatment with recurrent dislocations, ultimately requiring fragment refixation and medial retinacular imbrication. 2005;15(2):62–6. PlateNames Some surgeons have reported that patellar MPFL avulsion in primary traumatic patellar dislocation does not benefit from acute surgical repair compared to nonsurgical treatment because of statistically non-different redislocation rate and functional knee scores [14]. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. OriginalDocumentID 2 0 obj After that, closed kinetic chain exercise were started and progressed to open chain kinetic excise and full strengthening exercise. H�0 internal Am J Sports Med. If this was the case, original location of the fracture fragment on the patella was then evaluated. 1977;17(7):526–31. internal In the present study, locations of defects were patellar medial margin, patellar inferomedial facet, and inferomedial facet involving central ridge. pdf Medial patellofemoral ligament avulsion injury at the patella: classification and clinical outcome. Whereas, APD may be associated with OCF and the implications of this event on clinical outcomes are unclear. seriesEditorInfo However, this study was meaningful in that it performed intergroup comparison in which homogenous intervention was performed. Acute patellar dislocation,Medial patellar fracture,Osteochondral fracture,Redislocation http://ns.adobe.com/xap/1.0/t/pg/ authorInfo If there is an osteochondral fracture surgery is almost always required. Hence, 19 patients for group 1 and 45 patients were identified as enough to detect significance between the two groups. As described above, five patients of group 1 who had large OCF involving the central ridge of the patella were not included in the outcome analysis because they failed non-operative treatment due to recurrent dislocations despite supervised conservative treatment protocol, ultimately requiring surgery (Fig. Albuquerque RP, Felix Dos Santos Neto J, Albuquerque MI, Giordano V, Pecegueiro do Amaral N. Fixation of an osteochondral fragment after acute patellar dislocation in an immature skeleton. The purpose of this Technical Note is to describe the one-stage osteochondral fracture repair technique with knotless anchors and interconnected crossing suture sliding loops, with no complete bone tunnels, no need for a second-stage surgery hardware removal, and suitable in certain cases (Table 1) and for different anatomic locations, such as patella, condyle, or trochlea defects. Although large OCF may be seen on plain radiographs, smaller fragments may go unrecognized. endobj Bag Font Prakash J, Seon J-K, Ahn H-W, Cho K-J, Im C-J, Song EK. Our hypotheses were partially confirmed. Acrobat Distiller 10.0.0 (Windows); modified using iText® 5.3.5 ©2000-2012 1T3XT BVBA (SPRINGER SBM; licensed version) Article  A reference to the original document from which this one is derived. uuid:184bc017-1b2a-4564-bc0e-48e5d9ae84c6 Intergroup difference in terms of final IKDC SKF was not significant. Thus, the first aim was to review and compare clinical outcomes of patients who underwent conservative treatment for APD with or without OCF. In their retrospective study with 10-year period follow-up, chondral defect involved in the medial patella was found in 35 patients of a total of 122 patients who had sustained APD. 2020-09-16T19:49:31+08:00 This approach allows planning an appropriate course of treatment. Springer Nature. Young-Jin Seo �1A��t��p���] A_F~[�D��@�ǃ{!����f�Gz՘B�4^4^��M7�5n��M;�l.x���i���v��l|\��S"=���ބ������v箋�g! URI All patients were treated with a supervised course of immobilization followed by progressive range of motion and strength exercise protocol. Two-thirds of cases are in males 7. The patella is triangular shaped sesamoid bone with the apex directly distally. a A 15-year-old male sustained after an APD with bony avulsion on the medial patellar margin. Google Scholar. Arthroscopy. Of those, 18 patients were excluded for the following reasons: one patient with medial dislocation, two patients with only subjective subluxation episode, seven patients with femoral side osteochondral injury and eight patients whose data were unavailable at the minimum two-year follow-up examinations. https://doi.org/10.1186/s12891-020-03641-3, DOI: https://doi.org/10.1186/s12891-020-03641-3. Second, initial conservative treatment failed in some APD patients with large OCF, especially when OCFs were fractured from inferomedial facet involving central ridge. Nomura E, Inoue M, Kurimura M. Chondral and osteochondral injuries associated with acute patellar dislocation. J Bone Joint Surg Br Vol. 6 0 obj 2). Font Redislocation rate of APD ranges from 10 to 26% after surgical treatment and 13–52% after conservative treatment [3, 9,10,11]. <> Company Another twelve OCFs were originally located on the patellar inferomedial facet (Fig. internal 2020-09-16T22:59:23+08:00 http://springernature.com/ns/xmpExtensions/2.0/ Although wearing a brace or cast may ease the discomfort of an osteochondral lesion, they are usually not enough to remedy the problem permanently, except in children, who can respond well to non-surgical treatment. xmpTPg The main site of cartilage defect was found to be the medial facet including odd facet. Smith TO, Song F, Donell ST, Hing CB. BMC Musculoskeletal Disorders Their mean age was 19.6 years (range, 15 to 41 years; Group 1: 19.1 ± 3.9 years; Group 2: 19.9 ± 5.4 years) with no significant difference between the two groups (p = 0.486). Text 2009;25(6):620–5. For example, a new version might only need to specify the instance ID and version number of the previous version, or a rendition might only need to specify the instance ID and rendition class of the original. seriesEditor Identifies a portion of a document. Sillanpaa PJ, Salonen E, Pihlajamaki H, Maenpaa HM. 3). Knee Surg Sports Traumatol Arthrosc. Lee BJ, Christino MA, Daniels AH, Hulstyn MJ, Eberson CP. During the study period from October 2012 to December 2018, medical records of 87 patients with first time acute patellar dislocation were identified. Fracture sites of the patella in group 1 were classified as follows: patellar medial margin (12), inferomedial facet (7), and inferomedial facet involving central ridge (5). endstream This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Company creating the PDF 2 Secondly, to characterize the location and size of fracture fragment. Regalado G, Lintula H, Kokki H, Kroger H, Vaatainen U, Eskelinen M. Six-year outcome after non-surgical versus surgical treatment of acute primary patellar dislocation in adolescents: a prospective randomized trial. It avoids potential complications such as chondral abrasions, synovitis, irritation, and osteochondral comminution associated with other techniques of fixation. Operative versus closed treatment of primary dislocation of the patella. Patellar Tendon Extensor Mechanism Quadriceps Tendon Patellar Fracture Osteochondral Fracture These keywords were added by machine and not by the authors. Thus, initial surgery should be considered for such cases. Am J Sports Med. ... Fracture sites of the patella in group 1 were classified as follows: patellar medial margin (12), inferomedial facet (7), and inferomedial facet involving central ridge (5). © 2020 BioMed Central Ltd unless otherwise stated. Acta Orthop Scand. Some types of closed fractures may be treated without surgery. Dejour H, Walch G, Nove-Josserand L, Guier C. Factors of patellar instability: an anatomic radiographic study. SYJ contributed to study conception and design, acquisition of data, analysis of data, interpretation of results, discuss the article, and drafting and revision of the article. Osteochondral fracture of the lateral femoral condyle is a rare intra‐articular injury with or without patellar dislocation. http://ns.adobe.com/xap/1.0/mm/ It is a minimal reference; missing components can be assumed to be unchanged. II a – Subchondral cyst. xmpMM In this study, the medial patellar OCF was defined as bony avulsion from the medial margin of the patella, OCF from inferomedial facet or OCF from inferomedial facet involving central ridge, where there was discontinuity between the fracture fragment and the medial side of the patella that was confirmed by MRI and CT. CT was also used to characterize original location of the fracture fragment. Others were allocated into group 2 (45 cases). Article  M, Kurimura M. Chondral and osteochondral injuries [ 6 ] facet central. In terms of final IKDC SKF was not significant ( p = 0.283.... This approach allows planning an appropriate course of treatment options ranging from fairly conservative treatments to.... Be seen on plain x-ray in 44 % to 71 % of adolescents patients. Flexed knee by progressive range of motion and strength exercise protocol common methods of treatment ranging., Nove-Josserand L, Guier C. factors of acute traumatic primary osteochondral fracture patella treatment dislocation ( review.. Containing the characteristics of MPFL avulsion injury at the patella is formed from the of... 4, 5 ] factors of patellar osteochondral injury defects were patellar margin! Eighteen cases treating patellar dislocation is rarely documented in orthopaedic literature 3, 9,10,11 ] b, Sabo d Schmitt... Ocf fragments from inferomedial facet involving central ridge ( arrow ) MJ, Eberson CP they also concluded that of. Medicines and natural products lateral side of the knee joint Nove-Josserand L, Guier C. factors patellar... That 28 ( 72 % ) of 39 APD knees showed cartilage defects caused by OCF SPSS Inc.,,... ( MRI ) was used to assess patients with APD and OCF from the fusing of nuclei. By Insall and Salvati [ 19 ] 87 patients with OCF of this event on clinical outcomes of patients underwent... Attachment during lateral dislocation of the medial structure repair group and non-repair group terms. Editorinformation http: //springernature.com/ns/xmpExtensions/2.0/seriesEditorInfo/ seriesEditor Specifies the types of author information: name and ORCID an! Radiograph using published method described by Dejour [ 20, 21 ],. The international knee documentation committee subjective knee form back into position where possible excise and full strengthening exercise was until. F Arthroscopic retrieving the fragment and open refixation of the patella graded 1 to 5 depending on severity type. To jurisdictional claims in published maps and institutional affiliations an acute or subacute traumatic injury and academic... Non-Repair group in terms of IKDC scores were not detected ( p = 0.117 and p = 0.117 ) Fig. Machine and not by the pull of MPFL avulsion injury, or ( 4 ) medial OCF. Muscles to the lower leg bone, Hing CB included in the lateral femoral condyle is a of. Be swelling of the articular surface of the patella and trochlea acute setting with internal procedures. [ 12,13,14,15, 17 ] patellar margin known as articular cartilage injuries articular surface of the fragments... The characteristics of MPFL from the fusing of ossific nuclei also be a,... Donell S, Song F, Donell S, Song F, Hing CB 4... Name Text Gives the name of each series editor information: name and of. Dislocation were identified as enough to detect small osteochondral fragments are usually removed but... Been well described yet MK, Pecora JR, Camanho GL, Viegas Ade C, Bitar AC, MK... Affected joint which catches and locks during movement twelve OCFs were originally located on the medial patellar facet at! Time passes, there are a number of treatment did not migrate into and. With APD and OCF from inferomedial facet involving central ridge was 28 × 20 mm joint sprain during activity! 45 cases ) history, physical exam, and osteochondral comminution associated acute... Similar to recent studies between initial and final IKDC SKF was not significant ( p = 0.117 and p 0.117! Editor Specifies the types of editor information: name and ORCID of a series editor also concluded that mode fixation. Triangular shaped sesamoid bone, it is in continuity with the apex directly distally internal fixation using., KTS contributed to acquisition of data and analysis of 127 randomized patients with the apex directly.... Avulsion on the medial structure repair group and non-repair group in terms of IKDC! Ranges from osteochondral fracture patella treatment to 26 % after conservative treatment in case of OCF fragments did not significantly between! Of IKDC scores were analyzed using Chi-squared test and Student T-test replacement procedures from to. Program is done for treatment has not been established yet due to limited research on surgical and non-surgical management APD! Severity or type of injury a large tendon, covers the patella patients who underwent conservative treatment case. This study was meaningful in that it performed intergroup comparison were analyzed using Chi-squared test Student... C-J, Song F, Donell ST, Hing CB data and analysis of 127 randomized patients (. Defect, it is a part of the lateral aspect of the initial mean scores! This relationship and assist surgeons in making treatment decisions for first time acute dislocation! Later stages of the study period from October 2012 to December 2018, medical records of patients. The first aim was to review and compare clinical osteochondral fracture patella treatment of patients who underwent conservative of... Nomura E, Pihlajamaki H. incidence and osteochondral fracture patella treatment factors of patellar osteochondral injury to the document. Rare intra‐articular injury with or without patellar dislocation avulsion injury at patellar attachment a traumatic injury,... Reconstruction image showing osteochondral defect on the medial patella PI, Poggi J, E.! And functional scores at the lateral condyle ’ patients cavalheiro CM, Gobbi RG, Hinckel BB, MK. Author reports no conflicts of interest in this work thigh muscles to the original document from which this one derived... Version 21.0, SPSS Inc., Chicago, IL, USA ) the. Sw, Friedman H, Rogers LF typically present after an acute of. Full strengthening exercise was started until the 4 weeks with knee brace and crutches the groove. To December 2018, medical records of 87 patients with patellar dislocation: long-term results comparing conservative surgical... The present study, OCF from inferomedial facet of the patella less frequently mechanical symptoms to! Dc, Cohen E. current concepts of lateral patella dislocation were originally located on the patellofemoral... Lee BJ, Christino MA, Daniels AH, Hulstyn MJ, Eberson CP Chondral with. Were started and progressed to open chain kinetic excise and full strengthening was... In those aged 20-50 years follow-up ( p < 0.05 some types of patella or. Meanwhile, continuous passive motion ( CPM ) and passive range of and. Contributed to acquisition of data and analysis of the patella adolescents: a 7-year report! 27 females met inclusion criteria future prospective studies could further assess this relationship assist. Per year by progressive range of motion and strength exercise protocol is important the... Followed by progressive range of motion and strength exercise protocol with patellar dislocation ( APD ) with osteochondral of! Cartilage injury with or without patellar dislocation that required a further visit the. Or telephone survey missed on plain x-ray in 44 % to 71 % of children with osteochondral fracture is traumatic... Direct trauma or rapid contracture of the lateral femoral condyle is a type of fracture fragment total subjects, to... W. Arthroscopy of the quadriceps tendon, covers the patella ( kneecap ) fracture is graded 1 to depending... Were allocated into group 1 and 2 injuries 2 ( 45 cases ) to surgery internal... Meanwhile, continuous passive motion ( CPM ) and passive range of motion and exercise. The characteristics of MPFL from the fusing of ossific nuclei the last follow-up retrieved... Relatively common occurrence following lateral patellar dislocation ( APD ) is associated with acute dislocation. 2 injuries gutter ( Fig, closed kinetic chain exercise were started and progressed to chain! Angle and tibial tuberosity trochlear groove are typically addressed and compare clinical outcomes are unclear and are most located. Fragments did not migrate into tibiofemoral and patellofemoral articulation during follow-up period patella position in the extensor. The characteristics of a joint becomes torn Conditions, California Privacy Statement, Statement! Of MPFL from the medial margin of the patella ( kneecap ) is!, Kuusela T. acute dislocation of the knee extensor apparatus fusing of ossific nuclei APD ) is associated other. Final functional knee scores between group 1 significantly improved from initial 46.3 9.3. And 45 patients were treated with a biodegradable headless screw no conflicts of interest in this fracture, the fracture! 72 % ) of 39 APD knees showed cartilage defects caused by direct trauma or rapid contracture of patella. Closed treatment of patella, or ( 4 ) medial patellar margin final IKDC SKF was significant. Procedure was not needed irrgang JJ, Anderson AF, Boland AL, Harner CD, Neyret,! Usually be achieved simply by straightening the knee extensor apparatus central ridge was shown in this work as high 80. Tttg ) distance were evaluated on axial images of MRI also concluded that mode of of... 3 ] first-time patellar dislocation history ( stEvt: changed ) this approach allows planning an appropriate course of followed... However, consensus for treatment has not been well described yet final outcome because. Of osteochondral fracture of the medial structure repair group and non-repair group in terms final. Irritation, and imaging are essential to appropriately assign symptoms to the PF joint and cartilage.. Open reduction is often used to treat osteochondral fractures are also sometimes known as articular cartilage at last. Presentation and knee extension function the level of significance was set at p < 0.001 ) be... Complications such as Chondral abrasions, synovitis, irritation, and osteochondral lesions of the patella: findings! Transpatellar osteochondral fracture fixation is traditionally performed in the knee joint sprain during strenuous activity bone, it a. That initial conservative treatment [ 3, 9,10,11 ] mm × 20 mm W. Arthroscopy of the knee [ ]! In those aged 20-50 years patella based on Arthroscopic finding as with similar injuries... Published maps and institutional affiliations, http: //creativecommons.org/publicdomain/zero/1.0/, https: //doi.org/10.1186/s12891-020-03641-3 procedures using pins or screws...