Follow on to the 29 year old athletic male with 3 days of le | Figure 1

Candlemaker

Orthopedic Surgery

Patient Case Summary

Follow on to the 29-year-old athletic male with 3 days of left knee pain, inability to bear weight, and large lateral femoral condyle osteochondral defect and matching loose body. Arthroscopy notes the large LFC defect and large loose body. Multiple smaller loose bodies were also removed. A lateral arthrotomy was made incorporating the lateral portal. The loose body was removed and is in the images. The loose body was mostly all cartilage with some bone attached that matched the bony defect in the images. When attempting to reduce the loose body, it did not fill the entire defect and left an approximate 1.5cm x 1cm defect superior to the main lesion that included the lateral articular margin.

Discussion Questions

Would you attempt to reduce and fix the OCD?
If you fix it, how could you fix it and what would you do about the remaining defect?
If you do not fix the OCD acutely, what would be the plan to address the lesion later?

Related Case Examples

Follow up case to open ankle fracture dislocation
- We reduced/fixed the medial malleolus.
- Reduced the fibula (making sure it is out to length), then applied 1/3 tubular overlapping plates to get a long enough plate for desired fixation.
- Reduced the syndesmosis with a large clamp over fibula and medial tibia and secured with fiberwire “tightrope” fixation.
- On the lateral approach to the fibula what nerve do you have to watch out for? And what do you do when the patient says they can’t move or feel their foot after surgery?
Another follow on case
- Follow on to the 29-year-old athletic male with left knee pain, inability to bear weight, and large lateral femoral condyle osteochondral defect and matching loose body. Other details included the removal of small loose bodies and discussion related to the treatment of the defect.
OCD lesion of talus
- Ankle arthroscopy for removal with debridement of osteochondral surfaces for pain relief.
17-year-old male patient injury
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