| Abstract ID |
| 20260058 |
| Category |
| Knee: Patellofemoral Joint |
| Preferable Presentation |
| Oral Presentation |
| Title |
| MINI-OPEN SUTURE FIXATION OF ACUTE OSTEOCHONDRAL FRACTURE OF THE PATELLA USING MENISCAL REPAIR NEEDLE: A CASE REPORT AND TECHNICAL NOTES |
| Author |
|
| Presenter |
| duc thinh le |
| Abstract |
| Background: Osteochondral fractures of the patella commonly result from acute patellar dislocations, particularly in adolescents. Surgical fixation is often required to restore the articular surface and prevent early osteoarthritis. There are many traditional fixation methods such as metallic screws, pins, or bioabsorbable implants. But they are associated with limitations, including high costs, potential for soft tissue damage, cartilage injury, or the need for secondary surgeries for hardware removal. An optimal technique that balances fixation stability with cost-effective, equipment availability and minimization of soft tissue damage has not yet been established. Objectives: To introduce a minimally invasive, cost-effective and simple suture fixation technique for treating patellar osteochondral fractures utilizing meniscal repair needles and to report the clinical outcomes of a case treated with this method. Study Design & Methods: This is a case report of a 15-year-old female who presented with a large (20 mm × 23 mm) free osteochondral fragment originating from the medial facet of the patellar and a complete medial patellofemoral ligament tear followed by a lateral patellar dislocation. The injury was managed via a mini-open medial parapatellar approach without patellar eversion. The osteochondral fragment was reduced and fixed using 2-0 FiberWire meniscal repair needles passed through 1.6-mm Kirschner wire tunnels in a triangular configuration, similar to the outside-in meniscal repair technique. Postoperative management included early partial weight-bearing and progressive range of motion exercises. Results: Intraoperative arthroscopy confirmed anatomic reduction and stable fixation of the fragment. At the 15-month follow-up, the patient demonstrated full restoration of knee function and successfully returned to pre-injury sports activities. Magnetic resonance imaging (MRI) confirmed complete osteochondral healing. Patient-reported outcome measures indicated excellent results, with a Subjective IKDC Score of 90, a Kujala Score of 92, and a Tegner Scale of 6. Conclusions: Suture fixation using meniscal repair needles is a viable, effective, and simple method for the management of patellar osteochondral fractures. This technique offers distinct advantages, including a minimally invasive approach that preserves soft tissue by avoiding patellar eversion, the use of widely available and cost-effective instrumentation, and the elimination of complications associated with rigid implants. The main limitations of this report are that it represents a single case and lacks direct comparative data with other fixation techniques; therefore, larger case series and comparative studies are required to validate the reproducibility, safety, and long-term outcomes of this technique. |