S82.01 Osteochondral fracture of patella

Name of the Condition

• Osteochondral fracture of patella

Summary

This condition involves a fracture of the patella (kneecap) that includes damage to both the bone and the overlying cartilage. The injury typically results from trauma and may involve displaced or non-displaced fragments, with the cartilage component distinguishing it from other patellar fractures.

Causes

Direct trauma to the knee, such as a fall onto the kneecap, a blow from an object, or a forceful contraction of the quadriceps muscle. High-impact injuries, like those from sports or motor vehicle accidents, are common triggers.

Risk Factors

• Participation in activities with a high risk of knee injury, such as contact sports or skiing.
• Osteoporosis or other bone-weakening conditions.
• Previous knee injuries or surgeries.
• Advanced age, which may reduce bone density.

Symptoms

• Sudden, severe pain in the knee.
• Swelling and bruising around the kneecap.
• Inability to straighten the knee or bear weight.
• Visible deformity or a gap in the kneecap area.
• A "popping" sensation at the time of injury.

Diagnosis

A physical examination to assess knee movement, swelling, and tenderness. Imaging studies, typically X-rays, to confirm the fracture and evaluate bone alignment. In some cases, a CT scan or MRI may be used to assess cartilage damage or complex fractures.

Treatment Options

• Conservative management: Immobilization with a brace or cast to allow healing, followed by physical therapy to restore mobility and strength.
• Surgical intervention: May be required for displaced fractures or significant cartilage damage, involving procedures to realign fragments or repair cartilage.

Prognosis and Follow-Up

Recovery depends on the severity of the fracture and cartilage involvement. Most patients regain function with appropriate treatment, but some may experience long-term stiffness or arthritis. Follow-up imaging and physical therapy are often recommended to monitor healing.

Complications

• Post-traumatic arthritis due to cartilage damage.
• Chronic knee pain or instability.
• Nonunion or malunion of the fracture.
• Infection or other surgical complications if intervention is required.

Lifestyle & Prevention

• Use protective gear during high-risk activities.
• Maintain bone health through adequate calcium and vitamin D intake.
• Strengthen knee muscles with targeted exercises to improve stability.
• Avoid sudden, forceful movements that strain the knee.

When to Seek Professional Help

Seek immediate medical attention if you experience severe knee pain, inability to bear weight, visible deformity, or a "popping" sensation after injury. Persistent pain, swelling, or difficulty moving the knee after initial treatment also warrants evaluation.

Tips for Medical Coders

Document the fracture type (e.g., displaced, non-displaced) and any associated cartilage damage to support the osteochondral fracture diagnosis. Ensure laterality (left/right) is specified if applicable. Include details of imaging or surgical findings to confirm the osteochondral nature of the injury.