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[Progress in surgical fixation methods for patellar osteochondral fractures following acute patellar dislocation]
Jingxin Li1, Li Gong2, Ming Zhou2
1Clinical Medical College, Jiangxi University of Chinese Medicine, Nanchang Jiangxi, 330004, P. R. China.
Objective:
To review the research progress on fixation methods for patellar osteochondral fractures (OCFs) following acute patellar dislocation.
Methods:
The domestic and foreign literature concerning the surgical fixation of patellar OCFs after acute patellar dislocation in recent years was extensively reviewed. The advantages, disadvantages, and indications of various surgical treatment methods were summarized.
Results:
Acute patellar dislocation is frequently complicated by patellar OCFs, which significantly impair patients' quality of life. Current surgical management of patellar OCFs primarily consists of two major strategies: reduction and internal fixation preserving the osteochondral fragment, and cartilage repair following fragment removal. Surgical reduction and internal fixation can maximally preserve the native hyaline cartilage and subchondral bone, holding significant importance for treating fragments that are difficult to repair. Internal fixation techniques include metal screw fixation, suture cerclage/circumferential fixation, bioabsorbable fixation, and combined fixation methods. The indications, advantages, and disadvantages of each surgical fixation method vary. Selecting an appropriate treatment regimen is crucial for clinical prognosis. Moreover, tissue engineering combined with regenerative medicine represents a promising synergistic strategy for integrated repair of refractory osteochondral defects.
Conclusion:
There are various surgical fixation methods for patellar OCFs resulting from acute patellar dislocation. To enhance surgical outcomes and reduce postoperative complications, the most suitable treatment strategy should be selected based on the size, location, and quality of the osteochondral fragment.