Adolescents are predisposed to osteochondral (OC) injuries in the knee. The medial facet of the patella, the femoral trochlea, and the lateral femoral condyle are the most common sites of injury. Most of these injuries are classically traumatic but noncontact injuries. Surgery is warranted in most cases of OC fracture. Depending on size, condition, and location of the lesion, options include OC fragment reduction and internal fixation or excision and cartilage resurfacing. Understanding of how to diagnose and treat OC fractures will help optimize outcomes.
[Show abstract][Hide abstract] ABSTRACT: Fixation of an osteochondral fracture after acute patellar dislocation is an infrequent form of treatment. Likewise, the location of this fragment in the lateral region of the lateral femoral condyle, functioning as a free body, is uncommon. The aim of this study was to present a case of osteochondral fracture of the patella at an unusual site, along with the therapy used and the clinical follow‐up.
Revista Brasileira de Ortopedia 03/2014; 49(2):202–205. DOI:10.1016/j.rbo.2014.01.013
[Show abstract][Hide abstract] ABSTRACT: Introduction:
Chondral injuries are becoming increasingly common in the paediatric knee. First line surgical therapy is usually microfracture (MF), but the emergence of alternative techniques raises the question of what is the optimal treatment in paediatric patients.
Sources of data:
A comprehensive search of PubMed, OVID, Web of Science, SportDiscus and Cochrane databases was performed using the key words 'autologous chondrocyte implantation, MF, mosaicplasty, juvenile, paediatric'.
Areas of agreement:
Each technique demonstrated a significant post-surgical improvement in clinical outcome scores. However, MF demonstrated poorer outcomes in larger lesions (>3 cm(2)) and shorter durability.
Area of controversy:
The quality of the available literature is poor, and there is a lack of comparative trials.
The impact of defect characteristics, mechanism of injury and concomitant surgeries should be investigated.
Areas timely for developing research:
Appropriately powered randomized controlled trials with suitably long follow up and condition-specific outcome measures should compare different techniques against each other and placebo.
British Medical Bulletin 10/2015; DOI:10.1093/bmb/ldv040 · 3.66 Impact Factor
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