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Case Rep Orthop. 2014;2014:876410. doi: 10.1155/2014/876410. Epub 2014 Nov 18.

Two patients with osteochondral injury of the weight-bearing portion of the lateral femoral condyle associated with lateral dislocation of the patella.

Case reports in orthopedics

Shuji Nakagawa, Yuji Arai, Hiroaki Inoue, Satoru Atsumi, Shohei Ichimaru, Kazuya Ikoma, Hiroyoshi Fujiwara, Toshikazu Kubo

Affiliations

  1. Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.

PMID: 25506015 PMCID: PMC4251879 DOI: 10.1155/2014/876410

Abstract

Complications of patellar dislocation include osteochondral injury of the lateral femoral condyle and patella. Most cases of osteochondral injury occur in the anterior region, which is the non-weight-bearing portion of the lateral femoral condyle. We describe two patients with osteochondral injury of the weight-bearing surface of the lateral femoral condyle associated with lateral dislocation of the patella. The patients were 18- and 11-year-old females. Osteochondral injury occurred on the weight-bearing surface distal to the lateral femoral condyle. The presence of a free osteochondral fragment and osteochondral injury of the lateral femoral condyle was confirmed on MRI and reconstruction CT scan. Treatment consisted of osteochondral fragment fixation or microfracture, as well as patellar stabilization. Osteochondral injury was present in the weight-bearing portion of the lateral femoral condyle in both patients, suggesting that the injury was caused by friction between the patella and lateral femoral condyle when the patella was dislocated or reduced at about 90° flexion of the knee joint. These findings indicate that patellar dislocation may occur and osteochondral injury may extend to the weight-bearing portion of the femur even in deep flexion, when the patella is stabilized on the bones of the femoral groove.

References

  1. Radiology. 1993 Oct;189(1):243-6 - PubMed
  2. Arthrosc Tech. 2013 Nov 15;2(4):e491-5 - PubMed
  3. Orthop Traumatol Surg Res. 2009 Feb;95(1):85-8 - PubMed
  4. Knee Surg Sports Traumatol Arthrosc. 2010 Nov;18(11):1470-5 - PubMed
  5. J Bone Joint Surg Br. 1976 Aug;58(3):287-90 - PubMed
  6. Rev Chir Orthop Reparatrice Appar Mot. 1978 Jul-Aug;64(5):423-8 - PubMed
  7. AJR Am J Roentgenol. 2006 Nov;187(5):1332-7 - PubMed
  8. Arthroscopy. 2005 Feb;21(2):228-32 - PubMed
  9. J Bone Joint Surg Br. 1964 Feb;46:40-5 - PubMed
  10. Am J Sports Med. 1998 Jan-Feb;26(1):52-5 - PubMed
  11. J Bone Joint Surg Br. 1976 May;58(2):237-40 - PubMed
  12. Knee Surg Sports Traumatol Arthrosc. 2005 Oct;13(7):522-8 - PubMed
  13. Am J Sports Med. 1986 Mar-Apr;14 (2):117-20 - PubMed
  14. Arthroscopy. 2003 Sep;19(7):717-21 - PubMed

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