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Int J Clin Pract 2022 21;2022:8220030. Epub 2022 Apr 21.

Orthopaedics and Traumatology Department, Sultan Abdulhamid Han Training and Research Hospital, Uskudar, Istanbul, Turkey.

Aim: Intramedullary nailing (IMN) is widely accepted as the treatment of choice for tibial fractures, and a suprapatellar method has been described to prevent common problems associated with the typical infrapatellar IMN technique, such as anterior knee pain. However, in the suprapatellar technique, injury to intra-articular structures is a concern. The aim of this study was to compare the clinical and radiological results of suprapatellar and infrapatellar IMN in terms of union, complications, and function. Read More

BMC Musculoskelet Disord 2022 Jun 6;23(1):539. Epub 2022 Jun 6.

Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.

Background: Displaced patella fracture is commonly treated with open reduction and internal fixation (ORIF). Wound complications after surgery often lead to prolonged hospitalization and dissatisfaction of patients. Periarticular adiposity and swelling may be associated with wound complications. Read More

BMJ Case Rep 2022 Jun 1;15(6). Epub 2022 Jun 1.

Trauma & Orthopaedics, University College London Hospitals NHS Foundation Trust, London, UK.

Vertical stress fractures of the patella are rare, with only a handful of bilateral cases reported. Stress fractures in the athletic community are often due to repetitive strain and submaximal loading, with minimal recovery time. An Olympic marathon runner in her 30s presented with right anterolateral knee pain. Read More

BMC Musculoskelet Disord 2022 May 14;23(1):452. Epub 2022 May 14.

Department of Orthopaedics and Trauma, Hong Hui Hospital, Xi'an Jiaotong, University College of Medicine, No. 555, East Youyi Road, Xi'an, 710000, Shaanxi, China.

Objective: An inferior pole fracture of the patella requires surgical treatment to restore the knee extension mechanism of the knee joint. Different from other types of patellar fractures, inferior pole fractures are usually comminuted, and other traditional fixation methods, such as tension band wiring, may not meet the fixation needs. We propose fixing inferior pole fractures of the patella with a custom-made anchor-like plate combined with cerclage and report the surgical outcomes. Read More

BMC Musculoskelet Disord 2022 May 9;23(1):431. Epub 2022 May 9.

Department of Orthopedic and Trauma Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Background: Open knee fracture-dislocation is a rare orthopedic injury. However, the importance of its correct management could not be overstated. To the best of our knowledge, this is the fifth study reporting a case with simultaneous Hoffa fracture and knee dislocation and the 1 study describing a patient with open plateau fracture-dislocation accompanied with Hoffa fracture, patella fracture, and patellar tendon tear. Read More

Am J Sports Med 2022 05 19;50(6):1635-1643. Epub 2022 Apr 19.

MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA.

Background: Cartilage transplants in the patellofemoral joint have demonstrated lower success rates than in the femoral condyles. This is likely related to the more complex morphology and biomechanics of the joint. While previous studies have evaluated cartilage surface matching and congruence, little work has been done to study the associated subchondral bone congruency in these grafts. Read More

J Knee Surg 2022 Apr 18. Epub 2022 Apr 18.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Currently, the management of acute osteochondral fractures (OCFs) of the patella is well established. However, the management of chronic OCFs remains debatable, as it is not clear whether such lesions can be accurately reduced or whether they will reliably heal. With well proven results of open reduction and internal fixation (ORIF) with headless compression screws (HCS) for acute OCFs, the application of this technique in late presenting cases is inconclusive. Read More

Injury 2022 Jun 1;53(6):1880-1886. Epub 2022 Apr 1.

University Hospitals Leuven, Department of Trauma Surgery, B-3000 Leuven, Belgium; KU Leuven, University of Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium. Electronic address:

Background: Fracture-related infection (FRI) after the operative management of patella fractures is a serious complication that can result in prolonged hospitalization, multiple revision procedures and permanent functional impairment. Till today, treatment modalities and outcome of FRI of the patella are not well described. Therefore, the main objective of this retrospective cohort study was to evaluate treatment options, functional outcome and healthcare costs related to FRI of the patella. Read More

JBJS Rev 2022 04 8;10(4). Epub 2022 Apr 8.

Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island.

»: An osteochondral fracture (OCF) of the patella or the femur is a frequent sequela after an episode of acute patellofemoral instability.

»: Patients commonly present with anterior knee pain after direct trauma to the patella or a noncontact twisting injury.

»: Radiographs and magnetic resonance imaging (MRI) are the most common imaging modalities that are used to diagnose OCFs. Read More

Int Orthop 2022 Jun 29;46(6):1395-1403. Epub 2022 Mar 29.

Zentrum Für Unfallchirurgie Und Orthopädische Chirurgie, BG Unfallklinik Frankfurt Am Main, Friedberger Landstrasse 430, 60389, Frankfurt am Main, Germany.

Purpose: The treatment of comminuted patellar fractures remains a challenge for orthopedic surgeons. The aim of this study was to assess the clinical, functional, and radiological outcome after treatment of comminuted patellar fractures using an anatomically contoured plating system.

Methods: Between January 2015 and December 2019 (5 years), 29 patients with complex C3 fractures according to AO classification (18 female, 11 male; mean age: 53 years) were treated using an anatomically contoured plating system (patella SuturePlate™, Arthrex®, Naples, USA). Read More

Asian J Surg 2022 07 15;45(7):1418-1419. Epub 2022 Mar 15.

Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei, China. Electronic address:

Khirurgiia (Mosk) 2022 (3):89-96

Samara State Medical University, Samara, Russia.

Objective: To improve postoperative outcomes in patients with closed patellar fractures using a new method of surgical treatment.

Material And Methods: The authors proposed a new method of patellar osteosynthesis. Technique of osteosynthesis is described, and surgical scheme is presented. Read More

Medicine (Baltimore) 2022 Mar;101(9):e28979

Department of Orthopedics, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Abstract: The technique of transosseous tunnels is widely used in lower pole patella fracture (LPP). Though the extensor mechanism can be restored, distal avulsion fragments are usually unstable. The subsequent fracture gap and nonunion impair the extensor mechanism in turn. Read More

Knee Surg Sports Traumatol Arthrosc 2022 Feb 26. Epub 2022 Feb 26.

Department of Orthopedic Sports Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Purpose: To investigate clinical and magnetic resonance (MR) imaging results of patients undergoing patella stabilization with either open flake refixation (oFR) or autologous chondrocyte implantation (ACI) and concomitant soft tissue patella stabilization after sustaining primary, acute patella dislocation with confirmed chondral and/or osteochondral flake fractures. It was hypothesized that refixation will lead to better results than ACI at mid-term follow-up.

Methods: A retrospective chart review was conducted to identify all patients undergoing oFR or ACI after sustaining (osteo-)chondral flake fractures and concomitant soft tissue patella stabilization following primary, acute patella dislocation between 01/2012 and 09/2018 at the author's institution. Read More

JBJS Case Connect 2022 02 24;12(1). Epub 2022 Feb 24.

Arthroplasty division, Department of Orthopaedics, Star Hospitals, Hyderabad, India.

Case: We report a very rare case of simultaneous ipsilateral floating hip and floating knee (SIFHFK) injury with the neck of the femur and patella fracture and hip dislocation associated with sciatic nerve injury in a 45-year-old man after a road traffic accident. We adopted a staged approach for surgical fixation of the fractures after stabilization. At the latest 2 years follow-up, the patient was asymptomatic with satisfactory clinical outcome. Read More

J Orthop Surg Res 2022 Feb 21;17(1):117. Epub 2022 Feb 21.

Department of Traumatic Orthopedics, Renmin Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, China.

Objective: The patellar inferior pole fracture is typically comminuted. Hence, achieving firm fixation and early activity is highly challenging. In this article, we employed the method of wire cerclage through a generated bone hole to reduce the fracture. Read More

Ann R Coll Surg Engl 2022 Jun 17;104(6):e190-e192. Epub 2022 Feb 17.

Sheffield Teaching Hospitals NHS Foundation Trust, UK.

We present a rare, previously undescribed case of a superior patella sleeve fracture in a skeletally immature adolescent male, just 1 month following surgery for an ipsilateral traumatic inferior pole patella fracture. This was initially missed resulting in a delay to surgery. We recommend a high index of suspicion is key in these patients who re-present following subsequent trauma and alternative X-ray views such as a flexed lateral can be extremely beneficial. Read More

Am J Sports Med 2022 03 10;50(4):977-983. Epub 2022 Feb 10.

Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA.

Background: Inferior pole patellar sleeve fractures (PSFs) are rare injuries that occur in skeletally immature patients that may be missed or falsely diagnosed as an inferior pole fracture (IPF) or Sinding-Larsen-Johansson syndrome (SLJS).

Purpose: The objective of this study was to evaluate and compare clinical and radiographic features of patients with PSF, IPF, and SLJS.

Study Design: Cross-sectional study; Level of evidence, 3. Read More

Zhongguo Gu Shang 2022 Jan;35(1):64-6

Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.

Eur J Trauma Emerg Surg 2022 Feb 2. Epub 2022 Feb 2.

Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey.

Purpose: We aimed to compare the accuracy of point-of-care ultrasonography (POCUS) and X-ray (XR) in the diagnosis of knee bone fractures and fracture characteristics in cases of injuries to the knee.

Methods: The study was conducted in the emergency department (ED) of a tertiary hospital between March 2017 and March 2019. It included patients who presented to the ED with isolated knee injuries, were suspected to have a bony lesion based on clinical examinations, and were ultimately referred for XR. Read More

Comput Math Methods Med 2021 31;2021:4964195. Epub 2021 Dec 31.

Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.

Objective: To evaluate the efficacy of suture anchor combined with double-pulley technique for subpatellar comminuted fractures compared with wire vertical suture and Krachow in the treatment of subpatellar fractures.

Methods: Retrospectively selected 48 patients with subpatellar pole comminuted fracture admitted in our hospital from February 2013 to July 2019, 25 patients with double-pulley technique (group A), and 23 patients with vertical wire suture with Krachow suture. Patient age, gender, AT/OTA typing, injury mechanism, follow-up time, surgical time, bleeding volume, mean fracture healing time, and postoperative complications were recorded. Read More

Orthop Surg 2022 Feb 29;14(2):374-382. Epub 2021 Dec 29.

Department of Orthopedics, The Second Hospital of Anhui Medical University, Hefei, China.

Objective: The study aim was to evaluate the clinical outcomes, functional outcomes, and postoperative complications of anchor and Krackow-"8" suture fixation (AS) and K-wire fixation in patients with distal pole patellar fractures.

Methods: Twenty-eight patients with distal pole patella fractures between January 2011 and December 2014 were reviewed retrospectively. The anchor and Krackow-"8" suture fixation (AS group) was applied in 10 patients and 18 patients underwent K-wire fixation (K-wire group). Read More

Skeletal Radiol 2022 07 23;51(7):1517-1520. Epub 2021 Dec 23.

Imaging and Interventional Radiology Centre, CUHK Medical Centre, 9 Chak Cheung Street, Shatin, New Territories, Hong Kong.

Skeletal Radiol 2022 07 20;51(7):1499-1501. Epub 2021 Dec 20.

Imaging and Interventional Radiology Centre, CUHK Medical Centre, 9 Chak Cheung Street, Shatin, New Territories, Hong Kong, Hong Kong.

Prague Med Rep 2021 ;122(4):308-312

Department of Emergency Medicine, Northwell Health Long Island Jewish Medical Center, USA.

A 49-year-old female fell from standing. Her right knee extended into the air. She had acute right knee pain preventing weight-bearing. Read More

Comput Math Methods Med 2021 1;2021:9572363. Epub 2021 Dec 1.

Department of Orthopaedic Surgery, Jiangmen TCM Affiliated Hospital of Jinan University, Jiangmen Guangdong 529000, China.

Objective: To analyse the X-ray and computed tomography (CT) findings of 128 patients with sports-related knee fractures and to improve the diagnosis rate based on the existing methods of diagnosis of sports knee fractures on X-ray and CT images.

Method: In this study, we retrospectively analyse the medical records of 128 cases of sports-related fractures in the hospital, analyse the results of X-ray examination and CT imaging of patients with sports knee fractures, and compare the results obtained by the two examination methods, while referring to MRI images performed.

Results: CT examination of knee fractures, tibial plateau fractures, and knee joint free body results were compared with X-ray results ( < 0. Read More

Arthroscopy 2021 12;37(12):3477-3478

University of Michigan.

While trochlear dysplasia is commonly discussed as a major risk factor for recurrent patellar instability, it also has a strong relationship with the development of patellofemoral cartilage lesions. Patellofemoral instability frequently occurs in teens and young adults, and the high prevalence of associated cartilage damage unfortunately sets patients up for the progression of degenerative changes of the patellofemoral joint at an early age. The judicious use of magnetic resonance imaging can help identify the presence of chondral lesions, allowing for urgent management of associated osteochondral fractures or open discussions and patient education about the possibility of performing a cartilage restoration procedure concurrently with patellar stabilization surgery. Read More

J Am Acad Orthop Surg Glob Res Rev 2021 12 2;5(12). Epub 2021 Dec 2.

From the Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, UK (Mr. Khan); Children's Hospital of Philadelphia (CHOP), Philadelphia, PA (Dr. Baghdadi and Dr. Ganley); Hospital of the University of Pennsylvania, Philadelphia, PA (Dr. Carey and Dr. Sheth); and Walsall Manor Hospital, Moat Road, Walsall, UK (Mr. Moores).

Osteochondral fractures of the knee occur frequently after acute patellar subluxation or dislocation. They can be challenging to manage because of the difficulty in diagnosing and treating these injuries in a timely fashion, in addition to choosing the optimum fixation method. This review presents the background, considerations for patient evaluation, and the best treatment options available for osteochondral fractures. Read More

Injury 2022 Feb 25;53(2):691-697. Epub 2021 Nov 25.

All India Institute of Medical Sciences, New Delhi, India.

Introduction: Patellar fractures constitute almost 1% of total skeletal injuries. Existing common operative methods include the use of different types of Tension band wiring techniques like cannulated screws and K-wires. The Patellar plating construct is a relatively newer operative method for patellar fracture fixation with promising outcomes with fewer complications. Read More

JBJS Case Connect 2021 10 20;11(4). Epub 2021 Oct 20.

Department of Orthopedic Surgery, Monmouth Medical Center, Long Branch, New Jersey.

Case: A 12-year-old boy sustained a patella sleeve fracture of the superior pole, medial patellofemoral ligament tear, and lateral femoral condyle fracture after a direct contact sledding injury. He was managed nonoperatively with 5 weeks of cylinder cast immobilization with transition to a hinged knee brace and physiotherapy. By 3 months, he returned to sport activity without patellar instability. Read More