Treatment of Knee Osteochondral Fractures

Suture Bridge Fixation in Treating Traumatic Femoral Osteochondral Injuries in Adults: A Case Study and Review of the Literature

Achieving anatomic reduction, securing fixation, and ensuring adequate compression are crucial steps in the internal fixation process for traumatic osteochondral defects. A variety of fixation methodologies have been in use, e.g., metal pins, bioabsorbable screws, and glue tissue adhesives, each of them yielding different outcomes. This study presents the outcomes of utilising the concept of suture bridge fixation for traumatic femoral osteochondral injury in a 34-year-old patient. Following a three-year follow-up, the patient demonstrated a return to normal activities with complete and pain-free knee mobility. In conclusion, it can be stated that suture bridges offer an alternative approach for the fixation of osteochondral fragments in the knee attributable to traumatic injuries.

Treatment of Knee Chondral Defects in Athletes

Cartilage lesions of the knee are a challenging problem, especially for active individuals and athletes who desire a return to high-load activities. They occur both through chronic repetitive loading of the knee joint or through acute traumatic injury and represent a major cause of pain and time lost from sport. They can arise as isolated lesions or in association with concomitant knee pathology. Management of these defects ultimately requires a sound understanding of their pathophysiologic underpinnings to help guide treatment. Team physicians should maintain a high index of suspicion for underlying cartilage lesions in any patient presenting with a knee effusion, whether painful or not. A thorough workup should include a complete history and physical examination. MRI is the most sensitive and specific imaging modality to assess these lesions and can provide intricate detail not only of the structure and composition of cartilage, but also of the surrounding physiological environment in the joint. Treatment of these lesions consists of both conservative or supportive measures, as well as surgical interventions designed to restore or regenerate healthy cartilage. Because of the poor inherent capacity for healing associated with hyaline cartilage, the vast majority of symptomatic lesions will ultimately require surgery. Surgical treatment options range from simple arthroscopic debridement to large osteochondral reconstructions. Operative decision-making is based on numerous patient- and defect-related factors and requires open lines of communication between the athlete, the surgeon, and the rest of the treatment team. Ultimately, a positive outcome is based on the creation of a durable, resistant repair that allows the athlete to return to pain-free sporting activities.

Fixation of a chondral lateral femoral condyle fracture in a 13-year-old boy following patella dislocation using a new suture technique

Osteochondral or, even more rarely, purely chondral fractures of the lateral femoral condyle following patella dislocation in adolescents are relatively infrequent. Various fixation methods are described in the literature, ranging from traditional screws to bioabsorbable constructs or the use of anchors. Each method possesses its own advantages and limitations. Here, we present a case involving a 13-year-old boy with a large purely chondral fracture of the lateral femoral condyle after patella dislocation, initially overlooked. We introduce a cost-effective suture-bridge technique for the fixation of this fracture, which eliminates the need for a second operation and has yielded favorable outcomes. It is important to know that fractures of this type can be easily overlooked, necessitating a high index of suspicion and the utilization of advanced imaging techniques to prevent potential long-term catastrophic outcomes for the knee joint.

Management of Juvenile Osteochondral Fractures Utilising Absorbable PLGA Implants

The incidence of articular injury, particularly osteochondral fractures (OCFs), has seen a cinnotable increase in recent years. Regardless of their location, fragments can be overlooked by plain radiographs, which might lead to osteoarthritis in the long run. Diagnostic imaging has a pivotal role in the assessment and classification of the fracture severity, as well as the presence of any associated dislocations. These fractures require surgical intervention for the restoration of joint function and the reduction of long-term complications. This paper aims to present the surgical correction and post-operative treatment of osteochondral fractures with absorbable implants in four children. The following affected areas are discussed: lateral condyle of the femur, patella and radial head. Utilising absorbable implants for the management of OCFs provides numerous advantages, including the elimination of the need for re-anaesthesia and reoperation, reduction of complications and facilitation of early rehabilitation. This approach also minimises the period of hospitalisation and proves effective in pediatric OCF treatment.

Arthroscopic In Situ Fixation of Osteochondral Fragments on the Weightbearing Area of the Knee Joint With a Single Anchor

Osteochondral fracture of knee joint occurring in the femur is a serious clinical trauma. The presence of osteochondral fragments in the knee joint often necessitates surgery. Arthroscopic repair is a minimally invasive treatment, and there are many methods, among which suture anchor is often adopted by clinicians because of its obvious advantages such as simplicity. In the past, there were many methods for fixing osteochondral fragments, but using suture anchors to fix free osteochondral fragments has become a common approach. Moreover, the local mechanical environment will also be affected because of the increase in the number of bone channels. In this report, we describe a method for fixing 1 or 2 osteochondral fragments using a single suture anchor based on the mechanical characteristics of the femoral weightbearing region of the knee joint. We use relevant case reports to introduce our technology. Through the application of our improved technique, the arthroscopic repair of osteochondral fractures in the weightbearing area of femur can be more convenient and more economical, and the rehabilitation of patients will not be affected.