Chondral Lesions and Patella Dislocation. Incidence, Characteristics and Treatment Options
Author(s):
Iosifidis M. (Greece)
,
Iosifidis M. (Greece)
Affiliations:
Melas I.
,
Melas I.
Affiliations:
Petras K.
,
Petras K.
Affiliations:
Sakkorafas N.
,
Sakkorafas N.
Affiliations:
Gkikas G.
,
Gkikas G.
Affiliations:
Metaxiotis D.
,
Metaxiotis D.
Affiliations:
Mpeletsiotis A.
Mpeletsiotis A.
Affiliations:
ESSKA Academy. IOSIFIDIS M. 05/09/18; 209691; P12-1273 Topic: Sports Related Injuries
Dr. Michael IOSIFIDIS
Dr. Michael IOSIFIDIS
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Abstract
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Objectives: Patella dislocation is associated with chondral lesions many times, which influences significantly the treatment strategy. The aim of this case series study was to present the incidence, characteristics and treatment options for the associated cartilage lesions after patella dislocation.

Methods: Thirty-six patients (male:female 20:16 mean age 16.47/12-39 years), out of 64 with patella dislocation during a 3-years period, are included in the study's cohort. They presented either after first acute patella dislocation (n=21), or after an episode of recurrent patella dislocation or referring recurrent patella dislocation (n=15). Chondral and osteochondral lesions (n=40) were diagnosed by MRI and/or x-rays in 32 cases (88.9%), whereas in 4 cases (11.1%) the lesions were missed during the 1st evaluation. They were isolated or combined lesions at patella medial facet or/and inferomedial pole (n=31), and at lateral femoral condyle (n=6). MPFL repair (n=9) and MPFL reconstruction was performed (n=27), which was combined with tibial tubercle anteromedialization (Fulkerson procedure) in 4 cases, and trochlioplasty in 1. For the cartilage defects absorbable pins fixation was used (n=14), whereas in the rest bone marrow stimulation techniques (n=4), AMIC (n=12) and ACI/MSCs (n=6) were performed. The patients were followed up in 3rd, 6th, 12th and 24th p.o. month using the KOOS and IKDC scoring scales (the non-parametric Wilcox Signed Ramk test was used to evaluate the differences between the pre- and postoperative values; p<0.05).

Results: No complications or adverse events were reported. No new episode of dislocation or subluxation of the patella was recorded. Analysis of the results (mean follow-up 22.5 months) showed a significant increase in the mean values of the IKDC total score (from 46.1 to 74.5 p=0.05) and all KOOS subscales only after the 12th p.o. month.

Conclusions: Chondral lesions associated with patella dislocation is a relatively common injury. A high awareness of cartilage injury is needed after an acute patella dislocation. The surgical treatment of patella dislocation and the chondral lesion in one stage is a demanding but reproducible procedure.

Keywords:
Patella dislocation, chondral lesion
Objectives: Patella dislocation is associated with chondral lesions many times, which influences significantly the treatment strategy. The aim of this case series study was to present the incidence, characteristics and treatment options for the associated cartilage lesions after patella dislocation.

Methods: Thirty-six patients (male:female 20:16 mean age 16.47/12-39 years), out of 64 with patella dislocation during a 3-years period, are included in the study's cohort. They presented either after first acute patella dislocation (n=21), or after an episode of recurrent patella dislocation or referring recurrent patella dislocation (n=15). Chondral and osteochondral lesions (n=40) were diagnosed by MRI and/or x-rays in 32 cases (88.9%), whereas in 4 cases (11.1%) the lesions were missed during the 1st evaluation. They were isolated or combined lesions at patella medial facet or/and inferomedial pole (n=31), and at lateral femoral condyle (n=6). MPFL repair (n=9) and MPFL reconstruction was performed (n=27), which was combined with tibial tubercle anteromedialization (Fulkerson procedure) in 4 cases, and trochlioplasty in 1. For the cartilage defects absorbable pins fixation was used (n=14), whereas in the rest bone marrow stimulation techniques (n=4), AMIC (n=12) and ACI/MSCs (n=6) were performed. The patients were followed up in 3rd, 6th, 12th and 24th p.o. month using the KOOS and IKDC scoring scales (the non-parametric Wilcox Signed Ramk test was used to evaluate the differences between the pre- and postoperative values; p<0.05).

Results: No complications or adverse events were reported. No new episode of dislocation or subluxation of the patella was recorded. Analysis of the results (mean follow-up 22.5 months) showed a significant increase in the mean values of the IKDC total score (from 46.1 to 74.5 p=0.05) and all KOOS subscales only after the 12th p.o. month.

Conclusions: Chondral lesions associated with patella dislocation is a relatively common injury. A high awareness of cartilage injury is needed after an acute patella dislocation. The surgical treatment of patella dislocation and the chondral lesion in one stage is a demanding but reproducible procedure.

Keywords:
Patella dislocation, chondral lesion
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