Adolescent Femoral Chondral Fragment Fixation With Poly-L-Lactic Acid Chondral Darts.

Area of Science:

• Orthopedics
• Sports Medicine
• Regenerative Medicine

Background:

• Large chondral injuries without attached bone are uncommon, posing significant treatment challenges.
• This case involves a 14-year-old male athlete experiencing a unique stress reaction leading to a displaced full-thickness articular cartilage lesion.

Observation:

• The patient sustained a 2.5 × 2.5-cm full-thickness articular cartilage lesion of the anterior lateral femoral condyle.
• Significant delamination was noted, suggesting a prodromal stress reaction despite the absence of subchondral bone in the fragment.

Findings:

• Surgical repair involved returning the cartilage-free fragment to the donor site and fixation with poly-L-lactic acid chondral darts.
• Despite the delayed treatment and fragment characteristics, the knee injury healed completely.
• Postoperative magnetic resonance imaging and 1-year follow-up confirmed cartilage healing and full functional recovery.

Implications:

• Prompt recognition and surgical repair are crucial for optimal outcomes in such rare cartilage injuries.
• The poly-L-lactic acid chondral dart system proved instrumental in the successful fixation and healing of the cartilage fragment.
• This case underscores the potential for successful management of large, bone-free articular cartilage defects with appropriate surgical techniques.