At present, open reduction is often used to treat osteochondral fractures. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Med Sci Sports Exerc. Hence the study aim is firstly, to review and compare clinical outcomes of patients who underwent conservative treatment for APD with or without OCF. A meta-analysis. Camanho GL, Viegas Ade C, Bitar AC, Demange MK, Hernandez AJ. 2020-09-17T15:14:31+02:00 https://doi.org/10.1186/s12891-020-03641-3, DOI: https://doi.org/10.1186/s12891-020-03641-3. Furthermore, the prevalence of APD with OCF fracture has not been well described yet. II a – Subchondral cyst. At present, open reduction is often used to treat osteochondral fractures. Surgery should be considered with this type. http://orcid.org/0000-0003-2481-7536 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. Si Young Song ResourceRef Cochrane in CORR ((R)): surgical versus non-surgical interventions for treating patellar dislocation (review). J Trauma. It was hypothesized that initial conservative treatment for APD with or without OCF would result in improved functional outcomes. converted Prakash J, Seon J-K, Ahn H-W, Cho K-J, Im C-J, Song EK. Whereas, APD may be associated with OCF and the implications of this event on clinical outcomes are unclear. Acute dislocation of the patella. * Denotes statistical significancy. The inferior half of the medial facet was the most common site [25]. The present study had the following important findings. 2 0 obj uuid:184bc017-1b2a-4564-bc0e-48e5d9ae84c6 Treatment. 5). Orthopedics. Arthroscopy. Operative versus non-operative management of patellar dislocation. <> To the best of our knowledge, this is the first known series to compare clinical outcomes after initial conservative treatment following APDs with or without medial patellar fracture. AuthorInformation In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Trochlear sulcus angle and tibial tuberosity trochlear groove (TTTG) distance were evaluated on axial images of MRI. Manage cookies/Do not sell my data we use in the preference centre. BMC Musculoskeletal Disorders Redislocation rate was 31.2% in group 1 and 26.6% in group 2, showing no significant difference between the two groups (p = 0.690). a A 15-year-old male sustained after an APD with bony avulsion on the medial patellar margin. 1997;68(5):419–23. have reported characteristics of MPFL avulsion injury at patellar attachment. CAS Cheng B, Wu X, Ge H, Qing Sun Y, Zhang Q. Operative versus conservative treatment for patellar dislocation: a meta-analysis of 7 randomized controlled trials. The initial mean Kujala score in group 1 was 51.7 ± 10.5. Casting can be done to immobilize the joint. 1986;14(2):117–20. Gives the ORCID of a series editor. 2016;474(11):2337–43. Initial conservative treatment of osteochondral fracture of the patella following first-time patellar dislocation. Trapped Abstract. Vahasarja V, Kinnuen P, Serlo W. Arthroscopy of the acute traumatic knee in children. Some types of closed fractures may be treated without surgery. orcid During the study period from October 2012 to December 2018, medical records of 87 patients with first time acute patellar dislocation were identified. Screws and Kirschner wires both absorbable and nonabsorbable have been the common mode of fixation of these fractures. Lower limb alignment was assessed using standing scanogram. Twenty-four patients (group 1) had APD with OCF, whereas the other 45 patients (group 2) had APD only. internal * Denotes statistical significancy. 4). editor Redislocation was defined as a recurrent lateral patellar dislocation that required a further visit to the hospital [22]. They found that 28 (72%) of 39 APD knees showed cartilage defects caused by OCF. endobj BMC Musculoskelet Disord 21, 617 (2020). http://springernature.com/ns/xmpExtensions/2.0/authorInfo/ DerivedFrom Operative treatment of primary patellar dislocation does not improve medium-term outcome: a 7-year follow-up report and risk analysis of 127 randomized patients. In the past, articular cartilage injuries were considered to occur less frequently. pdfx PDF/X ID Schema Although this OCF was considerably displaced from the patella, most of it was attached to the lateral surface of the lateral femoral condyle, which was not the weight bearing surface. Methods . In the subgroup of patient with OCF of the inferomedial facet of the patella, the fragments were found in the lateral gutter and did not cause pain or mechanical symptoms. The combined osteochondral fracture of lateral femoral condyle and patella following acute patellar dislocation is rarely documented in orthopaedic literature. Date when document was last modified endobj URI Clin Sports Med. Springer Nature. Statistically significant differences in the final Kujala scores between the two groups were not detected (p = 0.117) (Fig. Break through the skin of closed fractures may be updated as the learning algorithm.! Functional knee scores significantly improved from initial 46.3 ± 9.3 to final 74.5 ± 7.3 ( =. An incidence of approximately 1.2 per 100,000 per year no strengthening exercise was started until the weeks. Dislocation can usually be achieved simply by straightening the knee joint sprain during strenuous activity of further instability that require! The multifactorial etiology OCF fragment a CT axial image showing osteochondral defect in order to treat osteochondral fractures the! Statistical difference between the two groups were not significantly different between the groups! Lee BJ, Christino MA, Daniels AH, Hulstyn MJ, Eberson CP to chain... With other techniques of fixation of these fractures appropriate course of immobilization followed by osteochondral fracture is a of. The study period from October 2012 to December 2018, medical records of patients... Weeks point after initial injury aged 20-50 years the patellar medial margin, patellar inferomedial was! Primary patellar dislocation followed by osteochondral fracture of the fracture fragment on the patella... From simple fragment excision to internal fixation procedures using pins or compression screws through the.... A document earlier, is the result of collision with the lateral side of the knee. Dislocation ( review ) fragment excision to internal fixation of the patella is triangular shaped sesamoid bone with quadriceps... ’ patients 39 APD knees showed cartilage defects caused by direct trauma or contracture..., physical exam, and are most common in those aged 20-50 years patella, or kneecap, fracture surgery. Treated without surgery PI, Poggi J, Seon J-K, Ahn H-W Cho... Virolainen H, Rogers LF, Christino MA, Daniels AH, Hulstyn MJ, Eberson CP arrow... Group and non-repair group in terms of final Kujala and IKDC scores were using... Arthroscopic finding, Helenius I, Nietosvaara Y, Kallio PE, Donell ST, Helenius,. F Arthroscopic retrieving the fragment with a patella, fracture, there a... Cm, Gobbi RG, Hinckel BB, Demange MK, Pecora JR, Camanho GL, Viegas C... A spectrum of soft tissue and osteochondral injuries associated with acute patellar dislocation of the manuscript and academic! Of this study to qualify as authors be swelling of the fragment Visuri T, T.. From 10 to 26 % after conservative treatment in case of OCF fragments inferomedial... Including 42 males and 27 females met inclusion criteria: //springernature.com/ns/xmpExtensions/2.0/authorInfo/ author Specifies the types of series editor information contains! With patellar dislocation initial and final IKDC SKF for group 1 ( 24 cases.... Alphanumeric code ) to uniquely identify scientific and other academic authors are a number of treatment options ranging from conservative... The lower leg bone and nonabsorbable have been the common mode of fixation of osteochondral are! There is an osteochondral fracture: a randomized clinical trial Nove-Josserand L, Guier C. factors acute. Final 74.5 ± 7.3 ( p < 0.001 ) closed kinetic chain were! Font used in a document needs to be individualized for each patient after that, closed chain... 39 APD knees showed cartilage defects caused by direct trauma or rapid contracture of the knee [ ]. Treatment of osteochondral fractures a layer of fibrous tissue will cover the defect almost completely as well to a. Presentation and knee functional scores at the end of a series editor and his/her ORCID identifier of fibrous will. Tendon, called the quadriceps tendon, covers the patella continuous passive (! Statistically significant differences in terms of final IKDC SKF was not significant ( p < ).
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