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Fixation of a Chondral Fragment of the Knee in an AdultA Case Report
Jung Ho Noh, MD, PhD1; Sang Jun Song, MD, PhD2; Ji Yoon Bae, MD3; Young Hak Roh, MD4; Woo Kim, MD3; Bo Gyu Yang, MD3
1 Department of Orthopaedic Surgery, Kangwon National University Hospital, Chuncheon-si, Gangwon-do 200-722, South Korea. E-mail address: bestknee@hotmail.com
2 Department of Orthopaedic Surgery, Kyunghee University Medical Center, 23 Kyungheedae-ro, Dongdaemoon-gu, Seoul 138-708, South Korea
3 Department of Pathology (J.Y.B.) and Orthopaedic Surgery (W.K. and B.G.Y), National Police Hospital, 58 Garakbon-dong, Songpa-gu, Seoul 138-708, South Korea
4 Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, 1198 Kuwol-dong, Namdong-gu, Incheon 405-760, South Korea
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Investigation performed at the National Police Hospital, Seoul, Korea



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2012 Dec 26;2(4):e83 1-5. doi: 10.2106/JBJS.CC.K.00084
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Extract

Chondral or osteochondral fractures of the patella or femoral trochlea are not uncommon. If the osteochondral fragment has sufficient subchondral bone, fixation of the fragment has been a treatment of choice1. However, partial or full-thickness chondral fracture has been managed in a different manner since cartilage itself has poor healing potential. Options to manage partial or full-thickness chondral injury include debridement, microfracture, drilling, osteochondral graft, and chondrocyte implantation. Fixation of a chondral fragment is not a standard method of treatment, especially in adults. There have been a few case reports of chondral fracture managed by fixation of a fragment in children or adolescents2,3. We present a case in which a full-thickness chondral fracture in an adult was treated with fixation of the fragment with a good short-term result. To our knowledge, this is the first report of a chondral fracture in an adult that was successfully treated by fixation, and was verified histologically. The patient was informed that data concerning this case would be submitted for publication, and he provided consent.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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