{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T12:36:46Z","timestamp":1793709406248,"version":"4.6.1"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n \n \n \u00bb An osteochondral fracture (OCF) of the patella or the femur is a frequent sequela after an episode of acute patellofemoral instability.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb Patients commonly present with anterior knee pain after direct trauma to the patella or a noncontact twisting injury.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb Radiographs and magnetic resonance imaging (MRI) are the most common imaging modalities that are used to diagnose OCFs.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb Arthroscopy may be indicated in cases of displaced OCFs, and the decision regarding osteochondral fragment fixation or loose body removal depends on fragment size, location, and extent of injury.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb Most of the current literature suggests worse outcomes for patients with OCFs who undergo nonoperative treatment, no significant differences in outcomes for patients sustaining an acute patellar dislocation with or without an OCF, and inconclusive results concerning outcomes for patients treated with loose body removal compared with fixation.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb Current outcome data are limited by studies with low levels of evidence; therefore, well-designed randomized controlled trials are needed.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>","DOI":"10.2106\/jbjs.rvw.21.00242","type":"journal-article","created":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T14:00:26Z","timestamp":1649426426000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Treatment of Osteochondral Fractures After Acute Patellofemoral Instability"],"prefix":"10.2106","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3207-0332","authenticated-orcid":false,"given":"Giancarlo","family":"Medina P\u00e9rez","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2947-1506","authenticated-orcid":false,"given":"Brooke","family":"Barrow","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4550-5833","authenticated-orcid":false,"given":"Van","family":"Krueger","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aristides I.","family":"Cruz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,4]]},"reference":[{"key":"r1-20240731","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1749-799X-7-21","article-title":"Primary traumatic patellar dislocation","volume":"7","author":"Tsai","year":"2012","journal-title":"J Orthop Surg Res"},{"issue":"455","key":"r2-20240731","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1097\/BLO.0b013e31802eb40a","article-title":"First-time traumatic patellar dislocation: a systematic review","volume":"455","author":"Stefancin","year":"2007","journal-title":"Clin Orthop Relat Res"},{"key":"r3-20240731","doi-asserted-by":"crossref","first-page":"473281","DOI":"10.1155\/2014\/473281","article-title":"Long-term follow-up of nonoperatively and operatively treated acute primary patellar dislocation in skeletally immature patients","volume":"2014","author":"Mostr\u00f6m","year":"2014","journal-title":"ScientificWorldJournal"},{"issue":"5","key":"r4-20240731","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1177\/0363546503260788","article-title":"Epidemiology and natural history of acute patellar dislocation","volume":"32","author":"Fithian","year":"2004","journal-title":"Am J Sports Med"},{"issue":"2","key":"r5-20240731","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1302\/0301-620X.58B2.932087","article-title":"Acute dislocation of the patella with osteochondral fracture: a review of eighteen cases","volume":"58","author":"Rorabeck","year":"1976","journal-title":"J Bone Joint Surg Br"},{"issue":"4","key":"r6-20240731","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1097\/01241398-199407000-00018","article-title":"Acute patellar dislocation in children: incidence and associated osteochondral fractures","volume":"14","author":"Nietosvaara","year":"1994","journal-title":"J Pediatr Orthop"},{"issue":"2","key":"r7-20240731","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1177\/036354658601400204","article-title":"Acute patellar dislocations. 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