What did the study look at?
Osteochondral fractures of the knee, in which joint cartilage breaks away together with the bone beneath it, are described by the authors as among the most common orthopaedic injuries, and their diagnosis and treatment remain debated among orthopaedic surgeons. Little information is available on delayed fixation.
This article describes the delayed fixation of a neglected osteochondral fragment, lying under the skin, from a large defect of the inner joint surface of the thigh bone (medial femoral condyle), and the result at 2 years.
How was it done?
This is a case report describing the treatment of a single patient. This summary is based on the article's abstract.
- Open surgery was performed through an incision along the inner edge of the kneecap (medial parapatellar approach).
- The fracture surface on the inner knob of the thigh bone was cleaned with a curette.
- A tricortical bone graft taken from the iliac crest (the rim of the pelvis) was placed into the defect.
- The osteochondral fragment was placed on top and fixed together with the graft using three headless compression screws to restore the joint surface.
What did it find?
The patient's Knee Injury and Osteoarthritis Outcome Score (KOOS) was 38 before surgery and rose to 74 during 2 years of follow-up.
The authors' conclusion
While acknowledging that information on delayed fixation of osteochondral fractures is scarce, the authors state that the successful outcome in this case supports the view that osteochondral fragments that remain viable should be fixed, regardless of timing.
Limitations
The abstract does not include a separate limitations section. Nevertheless, this is a report of a single patient, and its results cannot be generalised to other patients.
Note: this article was prepared from the paper's abstract, as automated access to the publisher's site was blocked.
Reference
Akkaya M, Simsek ME, Caglar C, Nazligul AS, Akcaalan S, Gürsoy S. Fixation of the neglected subcutaneous osteochondral fragment of large medial femoral condyle defect in adult male: A case report. Journal of ISAKOS. 2022;7(3):39-43. Licence: CC BY-NC-ND 4.0 (according to the publisher's open-access record).
DOI: 10.1016/j.jisako.2022.02.001
Free full text: Journal of ISAKOS (PDF)
This article summarises a published scientific paper for general information; it does not replace an examination or a personal medical assessment. Please consult your doctor about your symptoms.
