Simultaneous Osteochondral Fractures of the Medial Patella and Lateral Femoral Condyle Following Lateral Patellar...

Patellar dislocation most commonly occurs laterally and is associated with underlying anatomical abnormalities such as trochlear dysplasia and patella alta. While osteochondral injuries typically involve the lateral femoral condyle, simultaneous osteochondral fractures of the medial patella and lateral femoral condyle are extremely rare and often under-diagnosed due to subtle imaging findings and spontaneous patellar reduction. The purpose of this report is to highlight a rare injury pattern following lateral patellar dislocation and to emphasize the importance of early diagnosis using advanced imaging to prevent long-term complications. This retrospective case report describes a 22-year-old female patient who presented two weeks after a lateral patellar dislocation with knee pain and limited range of motion. Diagnostic imaging, including CT and MRI, was used to evaluate the extent of injury. The patient underwent surgical intervention consisting of arthroscopic and open fixation of osteochondral fragments using K-wires and ConMed smart nails, along with retinacular release. Postoperative outcomes were monitored over an eight-month period to assess recovery, range of motion, and symptom resolution. Intraoperatively, a large osteochondral fragment was found embedded in the medial patella, matching a defect in the lateral femoral condyle. Fixation was successful. At one-week follow-up, the patient showed improvement in pain and function. By eight months, she regained full range of motion, ligamentous stability, and resolution of symptoms. Simultaneous osteochondral injury to the medial patella and lateral femoral condyle is a rare but significant complication of lateral patellar dislocation. Prompt diagnosis and surgical fixation lead to favorable outcomes.