Unusual Association of Osteochondral Fracture of Patella with Adjacent Osteochondral Defect of Lateral Femoral Condyle: A Case Report and Review of Literature

Ronald Cabral; Ganesh Anantharamakrishnan; Arunkumar K. Vijaykumari; Ashwini Dondapati; Nithesh Jay Bensam; Abhiram Krishnan

doi:10.18502/jost.v11i4.20294

Ronald Cabral Junior Resident, Chettinad Hospital and Research Institute, Kelambakkam, Tamilnadu, India
Ganesh Anantharamakrishnan Assistant Professor, Chettinad Hospital and Research Institute, Kelambakkam, Tamilnadu, India
Arunkumar K. Vijaykumari Junior Resident, Chettinad Hospital and Research Institute, Kelambakkam, Tamilnadu, India
Ashwini Dondapati Junior Resident, Chettinad Hospital and Research Institute, Kelambakkam, Tamilnadu, India
Nithesh Jay Bensam Junior Resident, Chettinad Hospital and Research Institute, Kelambakkam, Tamilnadu, India
Abhiram Krishnan Junior Resident, Chettinad Hospital and Research Institute, Kelambakkam, Tamilnadu, India

DOI: https://doi.org/10.18502/jost.v11i4.20294

Keywords: Case Studies; Tissues; Microfractures

Abstract

Background: Incidence of osteochondral fractures with osteochondral bone defects without significant anterior cruciate ligament (ACL) injuries is rather uncommon with minimal literature available about the incidence rates of such lesions. Osteochondral injuries of the knee have different mechanisms of injuries like those following ACL rupture and patellar dislocation, which comprise direct and indirect modes of injuries. Various treatment modalities have been described for osteochondral defect depending upon the size of defect, such as debridement, lavage, microfracture technique, and osteochondral autograft transfer system (OATS) therapy. In case of osteochondral fractures, the main mode of management is surgical wherein osteochondral fractures are managed with headless compression screws and bioabsorbable implants. Robust management of the osteochondral fractures and osteochondral defects helps in achieving good prognosis for the patient.

Case Report: An 18-year-old young man presented with complaints of pain and inability to move his right knee following alleged history of twisting of right knee while playing football. On examination, the patient had moderate effusion in the knee with tenderness over the medial patellofemoral joint line. Radiological investigation revealed traumatic osteochondral fracture of the patella and incidental finding of osteochondral defect in the lateral femoral condyle which was managed surgically with Herbert headless screw fixation for fracture and debridement with microfracturing for osteochondral defect. Post-operatively, patient had good rehabilitation and regained his normal range of motion (ROM) at the end of 12 weeks.

Conclusion: The coincidental existence of both osteochondral fracture and osteochondral defect is a rare entity and warrants the need for surgical management to have better prognosis