Knee locking secondary to osteochondral fracture of the patella: an unusual presentation

Acute locking is a sign of internal derangement of the knee and is an orthopaedic surgical emergency. Differential diagnoses of this condition are torn meniscus, intra-articular loose bodies and torn anterior cruciate ligament. We present a 15-year-old schoolboy who developed acute locking of the knee during dancing. Arthroscopy revealed that he had sustained an osteochondral fracture of the patella and the loose fragment from it caused locking of the knee. That this was not pseudo-locking was confirmed by examination of the knee under anaesthesia. Locking of the knee by a loose osteochondral fragment following acute dislocation of the patella, though rare, should be considered as a possible cause of true locking.