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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2013

01-08-2013 | Knee

Adolescent patellar osteochondral fracture following patellar dislocation

Authors: Byung J. Lee, Melissa A. Christino, Alan H. Daniels, Michael J. Hulstyn, Craig P. Eberson

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2013

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Abstract

Purpose

Patellar dislocations in adolescents may cause osteochondral fractures of the patella. The aim of this study was to review the outcomes of adolescent patients who underwent surgical intervention for patellar osteochondral fracture following patellar dislocation.

Methods

Nine patients who underwent surgery for osteochondral fracture of the patella following dislocation were identified retrospectively. Following arthroscopic examination, if the fragment was large enough to support fixation, headless screws or bioabsorbable pins were used. Otherwise, the loose body was excised, and the donor site was managed with a microfracture. Postoperatively, patients were assessed using the International Knee Documentation Committee (IKDC) and Knee injury and Osteoarthritis Outcome Score (KOOS) outcome measures.

Results

The average age of the patients was 14.6 with average follow-up 30.2 months. Four of the nine patients underwent fixation, while five patients underwent removal of loose body with microfracture. The average defect size in the nonfixation group was 1.2 cm2 compared with 3.2 cm2 in the fixation group. The IKDC scores for fixation and nonfixation groups were 63.9 (SD = 18) and 76.1 (SD = 11.7), respectively. The KOOS subscale scores for symptoms, function in sports and recreation, and knee-related quality of life were higher for the nonfixation group when compared to the fixation group.

Conclusions

This is the first known series examining surgical outcomes of osteochondral fractures of the patella following patellar dislocations in the adolescent population. While patients without fixation were less symptomatic in this series, this may be attributable to more severe injuries in patients undergoing fracture fixation.

Level of evidence

Retrospective case series, Level IV.
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Metadata
Title
Adolescent patellar osteochondral fracture following patellar dislocation
Authors
Byung J. Lee
Melissa A. Christino
Alan H. Daniels
Michael J. Hulstyn
Craig P. Eberson
Publication date
01-08-2013
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-012-2179-z

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