{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:06:39Z","timestamp":1779357999278,"version":"3.51.4"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Currently, the management of acute osteochondral fractures (OCFs) of the patella is well established. However, the management of chronic OCFs remains debatable, as it is not clear whether such lesions can be accurately reduced or whether they will reliably heal. With well proven results of open reduction and internal fixation (ORIF) with headless compression screws (HCS) for acute OCFs, the application of this technique in late presenting cases is inconclusive. Thus, we present the clinicoradiological outcome of patients with chronic osteochondral injuries managed with ORIF. Fifteen patients who underwent surgical fixation by ORIF with HCS for chronic OCFs of the patella, between February 2013 and June 2018, were retrospectively analyzed after a mean follow-up of 3.8 years (range: 2\u20137 years). The mode of injury, size of the osteochondral fragment, and knee range of motion along with Kujala's scoring were examined clinically and radiological assessment was done by X-rays and magnetic resonance imaging (MRI) scans. Fifteen patients (11 males and 4 females), with a mean age of 17 years with chronic OCF of patella were enrolled. Noncontact twisting injuries were the most common mode of injury seen in 86.66% of patients and postcontact injuries in two patients (13.33%). The mean time from trauma to presentation was 7 weeks (range: 6\u201314 weeks). The mean preoperative Kujala's score improved from 44 to 84.8 at 6 months and 92.6 at 2 years, postoperatively. Intraoperatively, the lesion was found in medial patellar facet in 12 patients and 3 had lesions in the central facet. The mean size of the lesion was 20 mm\u2009\u00d7\u200918\u2009mm. Radiological union was observed in all patients, at a mean duration of 16 weeks (range: 12\u201320 weeks). One patient underwent implant removal 1 year after initial surgery for mechanical symptoms. ORIF of OCFs of the patella using headless cannulated screws is simple, reliable, reproducible, and provides satisfactory outcomes. This technique can be considered for fixation of fragments with adequate subchondral bone.<\/jats:p>","DOI":"10.1055\/s-0042-1744222","type":"journal-article","created":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T23:05:56Z","timestamp":1650323156000},"page":"894-899","source":"Crossref","is-referenced-by-count":1,"title":["Chronic Osteochondral Fractures of the Patella Managed with Open Reduction and Internal Fixation Yields Excellent Knee Function"],"prefix":"10.1055","volume":"36","author":[{"given":"Ravi","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5106-8502","authenticated-orcid":false,"given":"Vijay K.","family":"Digge","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5822-6916","authenticated-orcid":false,"given":"Tushar","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,4,18]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"crossref","first-page":"173","DOI":"10.21037\/atm.2019.03.52","article-title":"Clinical outcomes after absorbable suture fixation of patellar osteochondral fracture following patellar dislocation","volume":"7","author":"Z-X Li","year":"2019","journal-title":"Ann Transl Med"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1186\/s12891-020-03641-3","article-title":"Initial conservative treatment of osteochondral fracture of the patella following first-time patellar dislocation","volume":"21","author":"S Y Song","year":"2020","journal-title":"BMC Musculoskelet Disord"},{"issue":"08","key":"ref3","doi-asserted-by":"crossref","first-page":"1856","DOI":"10.1007\/s00167-012-2179-z","article-title":"Adolescent patellar osteochondral fracture following patellar dislocation","volume":"21","author":"B J Lee","year":"2013","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"12","key":"ref4","doi-asserted-by":"crossref","first-page":"2385","DOI":"10.1007\/s00264-013-2070-7","article-title":"Treatment of osteochondral fractures of the knee: a meta-analysis of available scientific evidence","volume":"37","author":"J K\u00fchle","year":"2013","journal-title":"Int Orthop"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1177\/036354658601400204","article-title":"Acute patellar dislocations. 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Res"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.otsr.2008.07.001","article-title":"Lateral femoral condyle osteochondral fracture combined to patellar dislocation: a case report","volume":"95","author":"A Callewier","year":"2009","journal-title":"Orthop Traumatol Surg Res"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.arthro.2004.09.029","article-title":"Osteochondral injury to the mid-lateral weight-bearing portion of the lateral femoral condyle associated with patella dislocation","volume":"21","author":"A A Mashoof","year":"2005","journal-title":"Arthroscopy"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"2325967116646085","DOI":"10.1177\/2325967116646085","article-title":"Concurrent validation of the Banff patella instability instrument to the Norwich patellar instability score and the kujala score in patients with patellofemoral 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