Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 13;35(1):10.
doi: 10.1186/s43019-023-00186-2.

The influence of primary treatment approach on outcomes in patients with osteochondral fracture after patellar dislocation: a case series

Mikko Uimonen  1   2 , Ville Ponkilainen  3 , Ville M Mattila  4   5   6 , Heikki Nurmi  3 , Juha Paloneva  3   7 , Jussi P Repo  5
Affiliations

The influence of primary treatment approach on outcomes in patients with osteochondral fracture after patellar dislocation: a case series

Mikko Uimonen et al. Knee Surg Relat Res. .

Abstract

Background: We characterized the relation of primary treatment approaches to the need of later surgical interventions and the outcomes of patellar dislocation in patients with patellofemoral osteochondral fracture (OCF).

Methods: Overall, 134 patients with OCF were categorized in two groups according to treatment approach: primary surgery (operation within 90 days from injury) and conservative treatment. Data on surgical procedures, OCF characteristics, and patellofemoral anatomy were retrospectively collected. To measure subjective outcomes, 54 patients completed the knee-specific patient-reported outcome measures (PROMs) Kujala score, Tegner activity scale, the knee injury and osteoarthritis outcome score (KOOS) quality of life (QoL) subscale, and visual analog scale pain items.

Results: The mean follow-up time was 4.9 years [standard deviation (SD) 2.7 years]. The primary treatment approach was surgery in 73 patients (54%) and conservative in 61 patients (46%) of whim 18 (30%) needed late surgery. Of primary surgery patients, the OCF was reimplanted in 45 patients (62%) and removed in the rest. Of all patients, 31 needed surgery in the later phase after the primary treatment approach (either reoperation or surgery after insufficient outcome of conservative treatment). In conservatively treated patients, OCF was smaller and patellofemoral joint malformation was more severe than in surgery group. Among patients who completed the PROMs, the outcomes appeared generally acceptable in both groups.

Conclusions: Although a majority of the primary treatment approaches for OCF after patellar dislocation were definitive, one-fourth of patients required surgery in the later phase. PROMs did not indicate major differences between the study groups.

PubMed Disclaimer

Conflict of interest statement

Dr. Uimonen reports personal scholarships from Tampereen Kaupungin Tiederahasto, Vappu Uuspää Foundation, and the Finnish Research Foundation for Orthopaedics and Traumatology. Other authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flowschart of patient selection
Fig. 2
Fig. 2
Pragmatic treatment protocol
Fig. 3
Fig. 3
Flowchart of treatment approaches
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Uimonen M, et al. Characteristics of osteochondral fractures caused by patellar dislocation. Orthop J Sports Med. 2021;9(1):2325967120974649. doi: 10.1177/2325967120974649. - DOI - PMC - PubMed
    1. Nietosvaara Y, Aalto K, Kallio PE. Acute patellar dislocation in children: incidence and associated osteochondral fractures. J Pediatr Orthop. 1994;14(4):513–515. doi: 10.1097/01241398-199407000-00018. - DOI - PubMed
    1. Seeley MA, Knesek M, Vanderhave KL. Osteochondral injury after acute patellar dislocation in children and adolescents. J Pediatr Orthop. 2013;33(5):511–518. doi: 10.1097/BPO.0b013e318288b7a0. - DOI - PubMed
    1. Smith TO et al (2015) Surgical versus non-surgical interventions for treating patellar dislocation. Cochrane Database Syst Rev (2): CD008106 - PubMed
    1. Stefancin JJ, Parker RD. First-time traumatic patellar dislocation: a systematic review. Clin Orthop Relat Res. 2007;455:93–101. doi: 10.1097/BLO.0b013e31802eb40a. - DOI - PubMed

LinkOut - more resources