S82.012 Displaced osteochondral fracture of left patella

Name of the Condition

• Displaced osteochondral fracture of left patella

Summary

This condition involves a fracture of the left patella (kneecap) where a portion of the bone and its attached cartilage is displaced from its normal position. The fracture affects both the bony and cartilaginous structures, and the displacement indicates that the fragments are not aligned properly.

Causes

Direct trauma to the knee, such as a fall onto the kneecap, a forceful blow, or a high-impact injury (e.g., motor vehicle accident or sports injury). The displacement occurs when the force is sufficient to separate the bone-cartilage fragment from the main patella.

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 left knee.
• Swelling and bruising around the kneecap.
• Inability to straighten or bear weight on the left knee.
• 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. CT or MRI may be used to assess cartilage damage or complex fractures.

Treatment Options

Treatment depends on the severity of displacement and cartilage involvement. Non-surgical options include immobilization with a brace, pain management, and physical therapy. Surgical intervention may be required for significant displacement, involving fragment reduction and fixation or cartilage repair.

Prognosis and Follow-Up

Prognosis varies based on treatment and injury severity. Recovery may take several weeks to months, with physical therapy often necessary to restore function. Follow-up imaging and clinical evaluations monitor healing and alignment.

Complications

Potential complications include chronic pain, arthritis, reduced knee mobility, or nonunion of the fracture. Cartilage damage may increase the risk of long-term joint degeneration.

Lifestyle & Prevention

Avoid high-impact activities that strain the knee. Strengthen quadriceps and hamstring muscles to support the patella. Use protective gear during sports and ensure proper footwear for stability.

When to Seek Professional Help

Seek immediate care for severe knee pain, inability to bear weight, visible deformity, or signs of infection (e.g., fever, redness). Persistent pain or swelling after initial treatment also warrants evaluation.

Tips for Medical Coders

Document the side (left), displacement status, and osteochondral involvement. Specify if the fracture is open or closed, and note the encounter type (e.g., initial, subsequent) for accurate coding. Ensure clinical details align with the code’s definition.