Treatment of Knee Osteochondral Fractures

Cordunianu, Mihai; Antoniac, Iulian Vasile; Niculescu, Marius; Păltânea, Gheorghe; Raiciu, Anca Daniela; Dura, Horațiu; Forna, Norin; Carstoc, Ioana Dana; Cristea, M

doi:10.3390/healthcare10061061

Cited by 7 publications

(5 citation statements)

References 71 publications

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“…These lesions may either be unstable OCD lesions, commonly seen in the pediatric population, or frank osteochondral fractures sustained after trauma, as in a direct blow to the knee by a helmet in football. 44,45 . In this technique, diagnostic arthroscopy is typically performed to evaluate the lesion.…”

Section: Osteochondral Fragment Internal Fixationmentioning

confidence: 99%

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Treatment of Knee Chondral Defects in Athletes

Thacher,

Pascual-Leone,

Rodeo

2024

Sports Medicine and Arthroscopy Review

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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.

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Section: Osteochondral Fragment Internal Fixationmentioning

confidence: 99%

“…In a select group of patients with unstable osteochondral fragments, fixation may be possible. These lesions may either be unstable OCD lesions, commonly seen in the pediatric population, or frank osteochondral fractures sustained after trauma, as in a direct blow to the knee by a helmet in football 44,45 …”

Section: Treatmentmentioning

confidence: 99%

Treatment of Knee Chondral Defects in Athletes

Thacher,

Pascual-Leone,

Rodeo

2024

Sports Medicine and Arthroscopy Review

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“…They are also often associated with sprains and dislocations, frequently in the elbow, ankle, knee (femoral condyles and patella) and hip joints [11]. At the knee joint, anterior cruciate ligament (ACL) injuries account for less than 1% of cases; however, it was found that the incidence of OCFs might be as high as 80% in the case of ACL injuries [1,[11][12][13]. This is attributed to the valgus stress, which results in shearing forces that damage the cartilage of the femoral condyles [1].…”

Section: Introductionmentioning

confidence: 99%

Management of Juvenile Osteochondral Fractures Utilising Absorbable PLGA Implants

Nudelman,

Lőrincz,

Lamberti

et al. 2024

JCM

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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.

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“…They are also often associated with sprains and dislocations, frequently in the elbow, ankle, knee -femoral condyles and patella -and hip joints [11]. At the knee joint, anterior cruciate ligament (ACL) injuries account for less than 1% of cases, however, it was found that the incidence of OCFs might be as high as 80% in the case of ACL injuries [1,[11][12][13]. This is attributed to the valgus stress which results in shearing forces yielding damage to the cartilage of the femoral condyles [1,11].…”

Section: Introductionmentioning

confidence: 99%

Management of Juvenile Osteochondral Fractures Utilising Absorbable PLGA Implants

Nudelman,

Lőrincz,

Lamberti

et al. 2023

Preprint

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The incidence rate of articular injury is on the rise. With the help of imaging techniques, we classify the severity of the fracture and possible dislocations. Therapeutic interventions include the use of absorbable implants. The paper aims to present the surgical correction and post-operative treatment of osteochondral fractures with absorbable implants in three children. Affected areas are discussed as follows: lateral condyle of the femur, patella, and radial head. 1) A nine-year-old girl heard a sharp sound accompanied by pain after taking a careless step. Slight swelling of the knee was observed with the patella in place. Diagnostics revealed a broken piece of the femur’s lateral condyle located at the lateral recess. Under general anaesthesia, an arthrotomy was performed. The fragment was cleaned and reattached with absorbable nails. Postoperatively, a brace was applied for six weeks. 2) A 15-year-old boy was admitted due to a fall during ice skating, leading to rotational torsion of the knee. X-ray and CT imaging identified the osteochondral fracture of the patella. Based on these findings, an arthroscopy with arthrotomy was performed. 3) A 17-year-old girl fell while snowboarding, resulting in swelling of the proximal forearm. Imaging diagnostics confirmed the radial head fracture. Closed-fracture repositioning with absorbable implants was performed. The use of biodegradable implants eliminates the need for re-anaesthesia and reoperation, reducing the risks of complications. It also allows for earlier initiation of rehabilitation including physiotherapy. The efficiency of the method is further increased by a minimised hospital stay.

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Treatment of Knee Osteochondral Fractures

Cited by 7 publications

References 71 publications

Treatment of Knee Chondral Defects in Athletes

Treatment of Knee Chondral Defects in Athletes

Management of Juvenile Osteochondral Fractures Utilising Absorbable PLGA Implants

Management of Juvenile Osteochondral Fractures Utilising Absorbable PLGA Implants

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