Treatment of Osteochondral Fractures After Acute Patellofemoral Instability: A Critical Analysis Review.

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.Arthroscopy may be indicated in cases of displaced OCFs, and the decision regarding osteochondral fragment fixation or loose body removal depends on fragment size, location, and extent of injury.Most of the current literature suggests worse outcomes for patients with OCFs who undergo nonoperative treatment, no significant differences in outcomes for patients sustaining an acute patellar dislocation with or without an OCF, and inconclusive results concerning outcomes for patients treated with loose body removal compared with fixation.Current outcome data are limited by studies with low levels of evidence; therefore, well-designed randomized controlled trials are needed.