L. Zuche (München, DE)
Klinikum rechts der Isar SportorthopädiePresenter Of 1 Presentation
P261 - Good Clinical & Radiological Outcomes after Flake Refixation and ACI Following Acute Patella Dislocation & Concomitant Flake Fractures
Abstract
Purpose
To investigate clinical & magnetic resonance (MR) imaging results of patients undergoing patella stabilization with open flake refixation (oFR) or autologous chondrocyte implantation (ACI) and concomitant soft tissue patella stabilization after sustaining acute patella dislocation with confirmed (osteo-)chondral flake fractures. It was hypothesized that refixation will lead to better results at mid-term follow-up.
Methods and Materials
Patients undergoing flake refixation or ACI after sustaining (osteo-)chondral flake fractures and concomitant soft tissue patella stabilization following acute patella dislocation between 01/2012-09/2018 were included. Exclusion criteria: age <14 years or >30; previous knee surgeries. Outcomes were assessed with Tegner activity score, Kujala score, subjective IKDC score, KOOS, MOCART 2.0 at a minimum follow-up of 24 months.
Results
Thirty patients were included (16 oFR; 14 ACI). Demographic data showed no significant group differences (oFR: 6 female, 10 males; age 26.9±5.9 years; ACI: 9 female, 5 male; age 25.8±5.1 years; n.s.). Similar Defect location in both groups. Both groups showed excellent clinical outcomes, no statistically significant difference between both groups. (oFR-group vs. ACI-group: Tegner: 5.1±1.8 vs. 5.1±1.4; Kujala: 86.1±12.6 vs. 84.9±9.1; IKDC: 83.8±15.0 vs. 83.6±11.3; KOOS: 83.3±14.0 vs. 83.6±12.0; n.s.) One patient in each group suffered a patella re-dislocation, needed revision surgery. MOCART 2.0 score showed good results for the oFR-group (68.2±11.1) and the ACI-group (61.1±16.9) with no significant differences. Inter-rater reliability was excellent (0.847).
Conclusion
Refixation of (osteo-)chondral fragments after sustaining acute patella dislocation with (osteo)-chondral flake fractures led to good clinical and radiological results at a minimum follow of 24 months, showing that it is a good surgical option. However, if open refixation is not indicated ACI may be an excellent fallback-option in these younger patients, with equally good clinical and radiological outcomes, however, requiring a second minimal-invasive surgery.
Presenter Of 1 Presentation
P261 - Good Clinical & Radiological Outcomes after Flake Refixation and ACI Following Acute Patella Dislocation & Concomitant Flake Fractures
Abstract
Purpose
To investigate clinical & magnetic resonance (MR) imaging results of patients undergoing patella stabilization with open flake refixation (oFR) or autologous chondrocyte implantation (ACI) and concomitant soft tissue patella stabilization after sustaining acute patella dislocation with confirmed (osteo-)chondral flake fractures. It was hypothesized that refixation will lead to better results at mid-term follow-up.
Methods and Materials
Patients undergoing flake refixation or ACI after sustaining (osteo-)chondral flake fractures and concomitant soft tissue patella stabilization following acute patella dislocation between 01/2012-09/2018 were included. Exclusion criteria: age <14 years or >30; previous knee surgeries. Outcomes were assessed with Tegner activity score, Kujala score, subjective IKDC score, KOOS, MOCART 2.0 at a minimum follow-up of 24 months.
Results
Thirty patients were included (16 oFR; 14 ACI). Demographic data showed no significant group differences (oFR: 6 female, 10 males; age 26.9±5.9 years; ACI: 9 female, 5 male; age 25.8±5.1 years; n.s.). Similar Defect location in both groups. Both groups showed excellent clinical outcomes, no statistically significant difference between both groups. (oFR-group vs. ACI-group: Tegner: 5.1±1.8 vs. 5.1±1.4; Kujala: 86.1±12.6 vs. 84.9±9.1; IKDC: 83.8±15.0 vs. 83.6±11.3; KOOS: 83.3±14.0 vs. 83.6±12.0; n.s.) One patient in each group suffered a patella re-dislocation, needed revision surgery. MOCART 2.0 score showed good results for the oFR-group (68.2±11.1) and the ACI-group (61.1±16.9) with no significant differences. Inter-rater reliability was excellent (0.847).
Conclusion
Refixation of (osteo-)chondral fragments after sustaining acute patella dislocation with (osteo)-chondral flake fractures led to good clinical and radiological results at a minimum follow of 24 months, showing that it is a good surgical option. However, if open refixation is not indicated ACI may be an excellent fallback-option in these younger patients, with equally good clinical and radiological outcomes, however, requiring a second minimal-invasive surgery.