Wall Shital N. Parikh INTRODUCTION Pathogenesis An osteochondral injury can occur in up to 71% to 93% of patients during an acute patellar dislocation.1,2 The chondral and osteochondral injury can vary from minor cartilage scuffing or fissuring, to large full-thickness free fragments greater than 3 cm diameter or… Twelve knees (31%) had cartilage injury of the lateral femoral condyle. Complications may include a patella fracture or arthritis.. A patellar dislocation typically occurs when the knee is straight and the lower leg is bent outwards when twisting. Dull, aching pain and/or a feeling of grinding when the knee is flexed may occur. Osteochondral Fracture and Patellar Instability Eric J. Sometimes the t… This fact reinforces the diagnosis of pre-fracture patellar dislocation. Patellar osteochondral fracture is an injury frequently associated with patellar instability, which may onset in the first episode. carefully and to avoid any activity in which symptoms of pain, swelling, or a feeling of instability are present. OCLs (osteochondral lesions of the talus) consist of damage or minor fractures to cartilage’s surface on the lower bone of the talus (ankle joint). Symptoms of an Osteochondral Fracture: Pain. An Osteochondral fracture is a tear of the cartilage which covers the end of a bone, within a joint. Inclusion criteria were: high-grade chondral lesions of PFJ (5 knees), or recurrent patella dislocations with trochlear dysplasia and chondral injury to the patella and/or trochlea (13 knees). Less common are impression fractures of the retropatellar joint or the lateral trochlea. Osteochondral injury to the patella is a relatively common occurrence following lateral patellar dislocation of the knee [ 13 ]. Osteochondral injury is commonly associated with immediate effusion that represents hemarthrosis or lipohemarthrosis. This study describes the incidence of osteochondral fractureand associated injury patterns in a pediatric population after first-time APD and assesses functional outcomesafter treatment. These osteochondral injuries typically involve the inferomedial pole, the median eminence of the patella , or both and can result either from a shearing injury at the time of dislocation or reduction or from an impaction injury as the patella strikes the nonarticular surface of the anterolateral femoral condyle. Pain with weight-bearing. Typically, this injury is a closed fracture. Our study group comprised 17 patients with patellar dislocation followed by osteochondral fracture of the articular surface of the patella. Acute patellar dislocation(APD) is a common injury in the pediatric patient population and may be associated with a spectrum of soft tissue and osteochondral injuries. BACKGROUND: Chondral or osteochondral avulsions of the lateral distal femur edge after luxation of the patella are well known. These can occur from an acute traumatic injury to the knee or an underlying disorder of the bone. chronic ACL tear. Possible locking feeling of the knee. However, during low-energy patellar dislocation, a lower incidence of osteochondral damage is reported. In the professional athlete, the prevalence of patellofemoral defects was 37%, with 64% of these being patellar.1 Similar findings have been described in pa- Pain results when the knee and the thigh bone (femur) rub together. In majority of the studies, patellar osteochondral fracture is associated with a bony contusion involving the lateral femoral condyle in the classical impaction pattern of injury [ 1 ]. Chondromalacia patella (knee pain) is the softening and breakdown of the tissue (cartilage) on the underside of the kneecap (patella). Osteochondral fractures are commonly associated with this injury, frequently necessitating surgical treatment. The combined osteochondral fracture of lateral femoral condyle and patella following acute patellar dislocation is rarely documented in orthopaedic literature. Often the knee is partly bent, painful and swollen. Alternatively, unstable OCD lesions may similarly present with pain, swelling, and mechanical symptoms. The main site of osteochondral fracture was the medial facet, and the main site of cracks was the central dome. A patellar dislocation is a knee injury in which the patella (kneecap) slips out of its normal position. S00-T88 Injury, poisoning and certain other consequences of external causes › S80-S89 Injuries to the knee and lower leg › S82-Fracture of lower ... S82.01 Osteochondral fracture of patella S82.011 Displaced osteochondral fracture of right patella . An osteochondral defect refers to a focal area of damage that involves both the cartilage and a piece of underlying bone. Based on the clinical, radiological, and arthroscopic examination, arthrotomy was performed by medial or lateral parapatellar incision beginning from the superior base of patella and ending in the inferior apex of patella by taking the affected articular surface as reference. The fracture bed on the patella and osteochondral fragments are debrided off necrotic tissues for a proper reduction. Traumatic patella instability episodes may result in chondral or osteochondral shear injuries to the medial patella, lateral trochlea, and/or lateral femoral condyle. Chondral and osteochondral injuries of the patella were classified into 3 groups. Magnetic resonance imaging (MRI) revealed a large osteochondral fracture on the chondral surface of the medial aspect of the lateral patellar facet as it abutted the central ridge, as well as 3 … The location of the abnormality is dictated by the mechanism of injury. The exact incidence and prevalence within … anterior aspect of lateral femoral chondyle and posterolateral tibial plateau Osteochondral Fractures are also sometimes known as articular cartilage injuries. All types of patella fractures may damage cartilage and therefore increase the risk of osteoarthritis, a degenerative condition of the joint that is characterized by cartilage damage. The mechanism of osteochondral injury during patella dislocation has been postulated to be excessive pressure applied to the articular surfaces as the patella moves over the lateral femoral trochlear groove in a slightly flexed knee. In this study, OCF from the patellar medial margin was defined as bony avulsion on the medial margin of the patella. Overdebridement is avoided to preserve the bone attached to the fragment. Patients can develop patellofemoral pain for several reasons, including acute trauma and overuse injuries. The underlying cause may be rooted in a chondral defect. The most commonly affected joint is the knee, with the majority of lesions located in the femoral condyle and/or patellofemoral articulation (Wheeless, 2012). Joint instability. 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. Introduction: Spectrum of disease entities from single, focal defects to advanced degenerative disease of articular (hyaline) cartilage; Epidemiology. Furthermore, on standard knee X-rays these injuries … The patella is also often felt and seen out of place. References Gudas R, et al: A prospective randomized clinical study of mosaic osteochondral autologous transplantation versus microfracture for the treatment of osteochondral defects in the knee joint in young athletes. The osteochondral autograG transplanta/on (OATS) procedure involves transplanta/on of plugs of bone with overlying ar/cular car/lage (Figure 3) from areas of rela/vely no weight bearing (Figure 2) to weight bearing areas of the knee which have ar/cular car/lage loss.2An allograG (cadaver) plug is also an op/on that can be used to fill the lesion. Patellar translation revealed stable patellofemoral ligaments. An injury to this cartilage and the underlying bone is called an osteochondral fracture. The medial location of the lesions and the involvement of the system of medial knee stability is a fundamental finding. A chondral defect refers to a focal area of damage to the articular cartilage (the cartilage that lines the end of the bones). Swelling. Several typical patterns of osteochondral injuries have been described in association with certain types of internal derangement and instability (11 – 13). 5-10% of people > 40 years old have high grade chondral lesions; location. Aim . Methods . Chondral and osteochondral injuries are often associated with acute traumatic dislocation. Subscribe to Codify and get the code details in a flash. From bone bruises to large osteochondral fractures, articular cartilage lesions have been reported in as many as 95% after patellar dislocation. The aim of the study was to analyze the clinical results and MRI scans after transpatellar osteochondral fracture fixation following patellar dislocation. This cartilage covers most of the talus, with the tibia (shin) and fibula (calf) bones above … Conclusions: From this study, articular cartilage injuries, especially of the patella, seem to be common occurrences after acute patellar dislocation. It is also known as Osteochondritis Dissecans and is common in the knee joint, especially in association with other injuries such as ACL tears. The only difference is that with an osteochondral fracture, there may also be a bone fracture involved. Patellar instability is a common cause for osteochondral injury of the patella. Request a Demo 14 Day Free Trial Buy Now Osteochondral defects (OCDs), often used interchangeably with osteochondritis dissecans in the juvenile population, are focal areas of articular cartilage wear/damage resulting in a loss of cartilage and inflammation of the adjacent subchondral bone (Juneau et al., 2016; Modarresi & Jude, 2015; Wheeless, 2012). It should be examined and addressed accordingly. incidence. 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