Healing of a Chondral Fragment of the Knee in an Adolescent After Internal Fixation

Chondral fragment of the lateral femoral trochlea of the knee in adolescents

“…We present here three cases of a purely chondral fragment from articular cartilage of the lateral femoral trochlea of the knee joint, all of which were successfully treated by surgical fixation, as previously reported as a rare injury by Nakamura et al [6].…”

“…Regarding the mechanism of this injury, Nakamura et al speculated, in their report [6], that a high velocity and low energy shearing force generated by a sudden twisting motion could have led to separation of the chondral layer. While shearing forces applied to the articular cartilage have been believed to cause osteochondral fractures in adolescents due to structural weakness of the osteochondral region [3], previous experimental studies indicated that the osteochondral junction was biomechanically vulnerable to shearing forces regardless of skeletal maturity, showing separation of the articular cartilage from the well-developed calcified cartilage layer [1,8].…”

“…Most injuries to the osteochondral region in adolescents have generally been believed to occur as osteochondral fractures [4,5]; however, Nakamura et al have reported a rare case of a purely chondral fragment from the articular cartilage of the knee which was successfully treated by fixation of the fragment accompanied by bone marrow stimulation [6]. We present here three similar cases with chondral fragment of the lateral femoral trochlea in the knee that was successfully treated by open reduction and fixation of the fragment with a minimum follow-up of two years, showing the incidence and the presumed mechanism of this injury.…”

Kniegelenktrauma mit Knorpelabscherverletzung

“…Osteochondral refixation shows good clinical results and should be primarily pursued whenever possible. [11]. In einem ak tuelleren Fallbericht wurde bei 3 jugend lichen Patienten ein rein chondrales Frag ment mit bioresorbierbaren Pins refixiert.…”

“…4 [11,23,26]. In einer aktu elleren Studie zu mittelfristigen Ergebnis sen nach osteochondraler Refixation mit resorbierbaren Implantaten zeigten sich im mittleren Followup von 6,5 Jahren sehr gute klinische Ergebnisse mit einem LysholmScore von 89 Punkten [25].…”