{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:02:58Z","timestamp":1788998578034,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,2,26]],"date-time":"2022-02-26T00:00:00Z","timestamp":1645833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,2,26]],"date-time":"2022-02-26T00:00:00Z","timestamp":1645833600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,2,26]],"date-time":"2022-02-26T00:00:00Z","timestamp":1645833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Deutsche Arthrosehilfe e.V."},{"name":"Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate clinical and magnetic resonance (MR) imaging results of patients undergoing patella stabilization with either open flake refixation (oFR) or autologous chondrocyte implantation (ACI) and concomitant soft tissue patella stabilization after sustaining primary, acute patella dislocation with confirmed chondral and\/or osteochondral flake fractures. It was hypothesized that refixation will lead to better results than ACI at mid\u2010term follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review was conducted to identify all patients undergoing oFR or ACI after sustaining (osteo\u2010)chondral flake fractures and concomitant soft tissue patella stabilization following primary, acute patella dislocation between 01\/2012 and 09\/2018 at the author\u2019s institution. Patients were excluded if they were aged\u2009&lt;\u200914 years or\u2009&gt;\u200930 and had previous knee surgeries at the index knee. Clinical outcomes were assessed using the Tegner activity score, Kujala score, subjective IKDC score, and the KOOS score at a minimum follow\u2010up of 24\u00a0months postoperatively. MR images were assessed using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0\u00a0knee score. Thirty patients were included in the study, with 16 patients assorted to the oFR group and 14 patients to the ACI group (Follow\u2010up 81%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Demographic data did not show significant group differences (oFR: 6 females, 10\u00a0males; age 26.9\u2009\u00b1\u20095.6 years, FU: 57\u00a0months (27\u201397\u00a0months); ACI: 9 females, 5\u00a0males; age 25.5\u2009\u00b1\u20094.9 years, FU: 51\u00a0months (29\u201391\u00a0months); n.s.). Defect location was similar in both groups (oFR: 12\u2009\u00d7\u2009patella\/4\u2009\u00d7\u2009lateral femoral condyle; ACI: 12\/2; n.s.). Both groups showed excellent clinical outcomes, with no statistically significant difference between both the groups (oFR group vs. ACI group: Tegner: 5.1\u2009\u00b1\u20091.8 vs. 5.1\u2009\u00b1\u20091.4; Kujala: 86.1\u2009\u00b1\u200912.6 vs. 84.9\u2009\u00b1\u20099.1; IKDC: 83.8\u2009\u00b1\u200915.0 vs. 83.6\u2009\u00b1\u200911.3; KOOS: 83.3\u2009\u00b1\u200914.0 vs. 83.6\u2009\u00b1\u200912.0; n.s.). One patient in each group suffered a patella re\u2010dislocation and needed revision surgery. The MOCART 2.0 score showed good results for the oFR group (68.2\u2009\u00b1\u200911.1) and the ACI group (61.1\u2009\u00b1\u200916.9) while no significant differences were noted between both the groups. The inter\u2010rater reliability was excellent (0.847).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Open refixation of (osteo\u2010)chondral fragments in patients after sustaining acute patella dislocation with (osteo)\u2010chondral flake fractures led to good clinical and radiological results at a minimum follow of 24\u00a0months, showing that it is a good surgical option in the treatment algorithm. However, if open refixation is not possible, ACI may be an excellent fallback option in these younger patients with equally good clinical and radiological outcomes, but requiring a second minimally invasive surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-06899-3","type":"journal-article","created":{"date-parts":[[2022,2,26]],"date-time":"2022-02-26T05:02:41Z","timestamp":1645851761000},"page":"3334-3342","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Excellent clinical and radiological outcomes after both open flake refixation and autologous chondrocyte implantation following acute patella dislocation and concomitant flake fractures"],"prefix":"10.1002","volume":"30","author":[{"given":"Yannick J.","family":"Ehmann","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Sports Medicine Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Zuche","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Sports Medicine Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schmitt","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Sports Medicine Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"},{"name":"<!--<label>3<\/label>--> OFZ Weilheim Weilheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P.","family":"Berthold","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Sports Medicine Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco\u2010Christopher","family":"Rupp","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Sports Medicine Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas N.","family":"Muench","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Sports Medicine Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Otto","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Sports Medicine Technical University of Munich Ismaninger Str. 22 81675 Munich Germany"},{"name":"<!--<label>2<\/label>--> Department of Trauma, Orthopaedic, Plastic and Hand Surgery University Hospital of Augsburg Augsburg 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