title: Adolescent patellar osteochondral fracture following patellar dislocation.
abstract: OBJECTIVE
  Patellar dislocations in adolescents may cause osteochondral fractures of the patella. The aim of this study was to review the outcomes of adolescent patients who underwent surgical intervention for patellar osteochondral fracture following patellar dislocation.
  
  
  METHODS
  Nine patients who underwent surgery for osteochondral fracture of the patella following dislocation were identified retrospectively. Following arthroscopic examination, if the fragment was large enough to support fixation, headless screws or bioabsorbable pins were used. Otherwise, the loose body was excised, and the donor site was managed with a microfracture. Postoperatively, patients were assessed using the International Knee Documentation Committee (IKDC) and Knee injury and Osteoarthritis Outcome Score (KOOS) outcome measures.
  
  
  RESULTS
  The average age of the patients was 14.6 with average follow-up 30.2 months. Four of the nine patients underwent fixation, while five patients underwent removal of loose body with microfracture. The average defect size in the nonfixation group was 1.2 cm(2) compared with 3.2 cm(2) in the fixation group. The IKDC scores for fixation and nonfixation groups were 63.9 (SD = 18) and 76.1 (SD = 11.7), respectively. The KOOS subscale scores for symptoms, function in sports and recreation, and knee-related quality of life were higher for the nonfixation group when compared to the fixation group.
  
  
  CONCLUSIONS
  This is the first known series examining surgical outcomes of osteochondral fractures of the patella following patellar dislocations in the adolescent population. While patients without fixation were less symptomatic in this series, this may be attributable to more severe injuries in patients undergoing fracture fixation.
  
  
  METHODS
  Retrospective case series, Level IV.
authors.affiliation: Department of Orthopaedics, The Warren Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI 02903, USA.
authors.forename: Byung J
authors.initials: BJ
authors.lastname: Lee
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Christino
authors.forename: Alan H
authors.initials: AH
authors.lastname: Daniels
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hulstyn
authors.forename: Craig P
authors.initials: CP
authors.lastname: Eberson
mesh_terms: D000293:Adolescent; D054544:Arthroplasty, Subchondral; D001858:Bone Nails; D001863:Bone Screws; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000209:etiology / Q000601:surgery*; D050724:Fractures, Cartilage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D007594:Joint Loose Bodies / Q000601:surgery; D008023:Ligaments, Articular / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D010329:Patella / Q000293:injuries / Q000601:surgery*; D031222:Patellar Dislocation / Q000150:complications*; D063868:Patient Outcome Assessment; D012008:Recurrence; D012189:Retrospective Studies