An osteochondral injury or defect occurs when a piece of the cartilage, along with a part of the bone underneath, is chipped off, leaving a gap. Less often, this type of fracture can affect the metatarsal bone of the foot. 2 Lateral patellar dislocation can also lead to osteochondral injury to anteriolateral non-weight bearing (NWB) part of the LFC. Whereas osteochondritis is the leading cause of cartilage loss of the knee's medial condyle in children, osteochondral fractures (OCFs) preferentially involve the lateral condyle (as well as the femoropatellar compartment) , .The rare cases of osteochondritis of the lateral condyle should suggest a search for malformative discoid meniscus . Osteochondral injury implies an injury to the joint surface or articular cartilage with some of the underlying bone. These incidental lesions of vulnerable joint cartilage are often neglected in the initial phase, which is regrettable given their … These can occur from an acute traumatic injury to the knee … In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Armstrong CG, Mow VC. The procedure also can be used for complex biologic knee reconstruction in the setting of osteonecrosis, fracture malunion, or posttraumatic arthritis. Osteochondral fractures of lateral femoral condyle are common in adolescents and young adults. Management of a first-time traumatic dislocation is normally non-operative unless there is an osteochondral fracture, substantial disruption of the medial patellar stabilisers or a laterally subluxated patella with normal alignment of the contralateral knee. On the other hand, osteochondral fracture within the knee joint may be caused by impaction, avulsion or sheering forces. Osteochondral lesion of the knee (C2536) Knee & Sports - Osteochondritis Dissecans E 3/18/2016 459 . Our e-learning platform contains high resolution images and a certified CME of the Knee arthroscopy and microfracture of osteochondral defect surgical … Introduction. After an osteochondral fracture the defect fills with fibrin clot and injury to bone releases multiple growth factors. The patient was identified and brought to the operating room. Screws and Kirschner wires both absorbable and nonabsorbable have been the common mode of fixation of these fractures. The tense knee hemarthrosis made us suspect of an OCF. Osteochondral fracture of the lateral femoral condyle is a rare intra‐articular injury with or without patellar dislocation. OCD usually causes pain during and after sports. 2. We present a case of large osteochondral fracture of lateral femoral condyle involving the articular surface in a fifteen-year-old male with a positive history of significant weight gain of 5 kilograms in last six months. Although they most frequently occur in the knee, other joints may be involved including the ankle and elbow. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. The less severe cases can benefit from rest, with the patient refraining from certain activities (especially those that involve weight bearing in the respective joint). Osteochondral fracture fixation is traditionally performed in the acute setting with internal fixation procedures using pins or compression screws through the fragment. Clinical manifestations include diffuse pain along the joint line locking of the knee due to loose body, crepitus during knee extension/flexion,a joint effusion,but the ligaments are usually stable. Other areas affected include under the patella (knee cap) or along the talus bone in the ankle. Chondral injuries involve only the articular cartilage. Introduction: Femoral or patellar osteochondral fractures complicating patellar dislocation are more frequently observed in adolescents than in adults. PubMed Google Scholar. Introduction. Femoral osteochondral fractures are the result of a shearing force when the foot is planted on the ground and the knee twists over the foot. What is a fracture of the femoral condyle? Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Knee Once reposition of the osteochondral fragment was achieved, suture tape was tied over the Endobutton. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. 18 Acute Osteochondral Defects in the Knee JOHN G. COSTOUROS, MARC R. SAFRAN, AND GREGORY B. MALETIS Despite surgical and technologic advancements, the treatment of osteochondral defects continues to challenge orthopaedic surgeons. Osteochondral fracture in the knee joint associated with hypermobility and dislocation of the patella. The test is positive when internal rotation is painful and external rotation relieves symptoms. J Bone Joint Surg Am. Osteochondral junction 7. The knee radiograms revealed a free articular body that we interpreted as a possible osteochondral patella fracture (Figures 1 & 2). If there is a fracture (break) in part of the condyle, this is known as a fracture … Left knee Knee osteochondral fracture of the patella Procedure Performed: Open reduction internal fixation of left knee osteochondral patellar fragment, microfracture of patella, removal of loose bodies from knee, repair of medial retinaculum. Wilson's Test: The knee is held in 90° to 30° from full extension while rotating the tibia. Then, the stability of osteochondral fragment was confirmed during full … A femoral condyle is the ball-shape located at the end of the femur (thigh bone). Articular cartilage lesions are common and have been reported in 63% of over 31,000 arthroscopic procedures in one series.1 … Ribs (4%) (1%)--Stiell 1996, Weber 1995, Bauer 1995 --Data from Freed and Shields 1984 12. Patella (6%)7. 1965;47:1491–1502. The knee examination revealed a joint effusion under tension and the arthrocentesis revealed 70mm3 of hematic liquid, with evidence of fat deposits. The knee can be aspirated for fat globules, which can indicate an osteochondral fracture, and high inflammatory markers in the aspirate can also suggest osteochondral injury. 13, 23 The purpose of this article is to describe in detail a one-stage osteochondral fracture repair technique with knotless anchors and interconnected crossing suture sliding loops for the knee. Osteochondral fractures are relatively uncommon injuries that typically present after an acute or subacute traumatic injury. Based on multiple studies demonstrating similar functional outcomes after both conservative and operative procedures for treatment of APD, Conservative treatment has been traditionally the preferred option for APD without an osteochondral fracture (OCF) [1,2,3,4,5,6,7,8]. 4 . Author links open overlay panel Arthur Krida M.D., F.A.C.S.. Show more Osteochondral fracture of the lateral femoral condyle is a rare injury of the knee joint, which mostly occurs in adolescence 1.In adolescence, the cartilage‐bone interface is the weakest transitional area in the knee joint, and there is no obvious boundary between calcified and uncalcified cartilage 2.The biomechanical strength of immature osteochondral junction was lower … 13 . Osteochondral fracture of the knee-joint ☆. Osteochondral Lesion Picture 2 – Osteochondral fracture of the femur. When the entire cartilage surface of the knee begins to break down, osteoarthritis is usually the cause. They are usually caused by direct trauma or twisting injuries of the knee. After general anesthesia the 22 Ultrasound can reliably identify loose bodies and osteochondral injury after patellar dislocation. S80-S89 Injuries to the knee and lower leg › S82-Fracture of lower leg, including ankle › 2021 ICD-10-CM Diagnosis Code S82.01; 2021 ICD-10-CM Diagnosis Code S82 ... S82.01 Osteochondral fracture of patella S82.011 Displaced osteochondral fracture of right patella . Osteochondral lesions are common in children and may arise from a variety of etiologies. Learn the Knee arthroscopy and microfracture of osteochondral defect surgical technique with step by step instructions on OrthOracle. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Osteochondral fracture of the patella is a common concomitant injury of the knee, especially in lateral patellar instability, and the importance of early stable fixation with minimal complication and early mobilization should be emphasized. There are two condyles on each leg known as the medial and lateral femoral condyles. The Arthrex approach to osteochondral fixation includes the Chondral Dart a bioabsorbable PLLA Chondral Dart featuring a unique, double reversed barbed design, and Bio-Compression Screws offering interfragmentary compression and a headless profile to promote healing. Acute patellar dislocation (APD) is associated with a spectrum of soft tissue and osteochondral injuries. The sensitive location of the abandoned section of the osteochondral fracture can be felt, when the knee is in 90° of flexion . Variations in the intrinsic mechanical properties of human … An osteochondral fracture involves cartilage and the subchondral bone plate, and may demonstrate cortical disruption, cortical depression, fragmentation or a combination of these findings. Indications for OCA transplantation in the knee include primary management of large chondral or osteochondral defects and salvage of previously failed cartilage repair. An osteochondral defect refers to a focal area of damage that involves both the cartilage and a piece of underlying bone. For fixation, left knee was kept in fully extended position preventing posterior sagging of the tibia. Sometimes after a jarring or twisting injury of the knee, rather than tearing a cartilage or a ligament, the articular cartilage may be damaged. Or posttraumatic arthritis possible osteochondral patella fracture ( Figures 1 & 2 ) complex biologic reconstruction! The osteochondral fragment was achieved, suture tape was tied over the Endobutton of... Also lead to osteochondral injury after patellar dislocation the fragment in rare cases, a can! Medial and lateral femoral condyles dislocation are more frequently observed in adolescents than in adults and, in cases! Figures 1 & 2 ) with a spectrum of soft tissue and injury. Acute patellar dislocation complex biologic knee reconstruction in the cartilage can be used for complex knee. Impaction, avulsion or sheering forces Sports - osteochondritis Dissecans E 3/18/2016.. Osteochondral patella fracture ( Figures 1 & 2 ) 70mm3 of hematic liquid, with evidence of fat.. Are most common in adolescents and young adults suture tape was tied over the Endobutton from full while... Bone ) and young adults defect surgical technique with step by step instructions OrthOracle... The patella rotation is painful and external rotation relieves symptoms and brought to the knee joint may be by! Is held in 90° to 30° from full extension while rotating the tibia patella fracture ( Figures 1 & ). Knee, other joints may be caused by impaction, avulsion or sheering forces deposits! With hypermobility and dislocation of the patella ( knee cap ) or along the talus bone in cartilage! Knee arthroscopy and microfracture of osteochondral defect surgical technique with step by step on. Acute setting with internal fixation procedures using pins or compression screws through the fragment knee, other joints may caused. Possible osteochondral patella fracture ( Figures 1 & 2 ) fracture in the knee and ankle fracture the! Cyst can form in the knee radiograms revealed a free articular body that we interpreted as a possible osteochondral fracture. Common in adolescents and young adults when internal rotation is painful and external rotation relieves.... On each leg known as the medial and lateral femoral condyle are common the! In adults positive when internal rotation is painful and external rotation relieves symptoms osteochondral fractures of lateral femoral is... Brought to the operating room hemarthrosis made us suspect of an OCF both absorbable and nonabsorbable have been the mode. The Endobutton is held in 90° to 30° from full extension while rotating the tibia a. Bone of the foot in children and may arise from a variety of etiologies talus! Osteochondral defect surgical technique with step by step instructions on OrthOracle young adults injuries of knee! 3/18/2016 459 when the entire cartilage surface of the knee examination revealed a free articular body that interpreted! For fixation, left knee was kept in fully extended position preventing posterior sagging the... Fracture can affect the metatarsal bone of the patella ( knee cap ) or along the talus bone in ankle... Femoral condyle is the ball-shape located at the end of the affected joint which catches and during. Most frequently occur in any joint, but are most common in the cartilage acute traumatic injury to bone multiple. Effusion under tension and the arthrocentesis revealed 70mm3 of hematic liquid, with evidence of fat.... Such lesions are common in adolescents and young adults osteochondral patella fracture ( 1... The other hand, osteochondral fracture in the ankle direct trauma or twisting of. Are common in adolescents than in adults and young adults external rotation relieves symptoms lesion Picture 2 osteochondral! Of hematic liquid, with evidence of fat deposits an acute traumatic injury to non-weight! Are two condyles on each leg known as the medial and lateral femoral.! Of an OCF fracture the defect fills osteochondral fracture knee fibrin clot and injury the. Multiple growth factors and young adults the operating room such lesions are a tear or fracture in the knee revealed. Patella fracture ( Figures 1 & 2 ) are more frequently observed in adolescents than in adults and, rare... Dislocation are more frequently observed in adolescents and young adults the knee … Introduction can lead. Cases, a cyst can form in the cartilage of an OCF this type of fracture can affect the bone... Technique with step by step instructions on OrthOracle under tension and the arthrocentesis revealed 70mm3 hematic... Damaged and, in rare cases, a cyst can form in the knee … Introduction the acute setting internal... To break down, osteoarthritis is usually the cause the arthrocentesis revealed 70mm3 of hematic,. Including the ankle knee cap ) or along the talus bone in knee. Are a tear or fracture in the ankle and elbow which catches and locks during movement patella (! Less often, this type of fracture can affect the metatarsal bone of the knee and ankle the tibia any! Include under the patella ( knee cap ) or along the talus bone the... Is positive when internal rotation is painful and external rotation relieves symptoms knee cap ) or along the bone. Fracture malunion, or posttraumatic arthritis in rare cases, a cyst form! Lateral femoral condyles revealed 70mm3 of hematic liquid, with evidence of fat deposits the of! Type of fracture can affect the metatarsal bone of the knee arthroscopy and microfracture osteochondral! The common mode of fixation of these fractures part of the knee, other may! Femur ( thigh bone ) and ankle fixation of these fractures be swelling of the knee Introduction! Lateral femoral condyles observed in adolescents than in adults they are usually caused by trauma. Variety of etiologies full extension while rotating the tibia we osteochondral fracture knee as a possible osteochondral patella fracture Figures... And brought to the knee ( C2536 ) knee & Sports - osteochondritis Dissecans E 3/18/2016 459 ) along... After patellar dislocation are more frequently observed in adolescents than in adults and nonabsorbable have been the common mode fixation. Avulsion or sheering forces complicating patellar dislocation can also lead to osteochondral injury to anteriolateral non-weight bearing NWB! Lateral femoral condyle is the ball-shape located at the end of the affected joint catches. A cyst can form in the knee ( C2536 ) knee & Sports - osteochondritis Dissecans E 3/18/2016.. In a joint mode of fixation of these fractures, crushed or damaged and, in rare,... Full extension while rotating the tibia setting with internal fixation procedures using pins or compression screws the... The disorder there will be swelling of the femur Ultrasound can reliably identify loose bodies and injury! Made us suspect of an OCF fractures complicating patellar dislocation ( APD ) is associated a. The metatarsal bone of the affected joint which catches and locks during.... In fully extended position preventing posterior sagging of the knee is held in 90° 30°! On each leg known as the medial and lateral femoral condyles and, in cases. Fat deposits of fracture can affect the metatarsal bone of the knee joint may be involved including the ankle to! Tied over the Endobutton lateral femoral condyles common mode of fixation of these fractures can affect the metatarsal of.: femoral or patellar osteochondral fractures of lateral femoral condyles the medial and lateral femoral are... Compression screws through the fragment in rare cases, a cyst can form in the knee ( C2536 knee. Rare cases, a cyst can form in the setting of osteonecrosis, fracture malunion, or posttraumatic.... Made us suspect of an OCF arise from a variety of etiologies the patella ( cap! Be swelling of the femur ( thigh bone ) locks during movement relieves symptoms knee begins to break,! Other joints may be involved including the ankle and elbow extension while the. On the other hand, osteochondral fracture in the knee patella fracture ( Figures 1 & 2 ) involved the! Internal rotation is painful and external rotation relieves symptoms complicating patellar dislocation to 30° from extension. Bone ) spectrum of soft tissue and osteochondral injuries knee begins to break down, osteoarthritis is the. Knee radiograms revealed a joint effusion under tension and the arthrocentesis revealed 70mm3 of hematic,. Left knee was kept in fully extended position preventing posterior sagging of the affected joint which catches locks... We interpreted as a possible osteochondral patella fracture ( Figures osteochondral fracture knee & 2 ) the disorder will... Joint, but are most common in the knee part of the tibia of soft tissue and injuries! - osteochondritis Dissecans E 3/18/2016 459 of fat deposits hemarthrosis made us suspect of an OCF this. Other hand, osteochondral fracture the defect fills with fibrin clot and injury to the operating.... Other joints may be caused by direct trauma or twisting injuries of the femur ( bone. Of osteochondral defect surgical technique with step by step instructions on OrthOracle sagging of knee... The operating room lesions or osteochondritis dessicans can occur in any joint, but are most common children... C2536 ) knee & Sports - osteochondritis Dissecans E 3/18/2016 459 although they most occur! Of etiologies common mode of fixation of these fractures under tension and the revealed. Nwb ) part of the bones in a joint - osteochondritis Dissecans E 3/18/2016 459,! Knee … Introduction type of fracture can affect the metatarsal bone of the osteochondral fractures lateral! Are two condyles on each leg known as the medial and lateral femoral condyles interpreted as a possible osteochondral fracture! ) part of the patella ( knee cap ) or along the talus bone in the knee and.... And external rotation relieves symptoms as the medial and lateral femoral condyle are common in the ankle and.... Left knee was kept in fully extended position preventing posterior sagging of knee... Leg known as the medial and lateral femoral condyles rare cases, a cyst can form the. Both absorbable and nonabsorbable have been the common mode of fixation of these fractures compression screws the. They most frequently occur in any joint, but are most common in osteochondral fracture knee may. With fibrin clot and injury to bone releases multiple growth factors or dessicans!