S82.014 Nondisplaced osteochondral fracture of right patella

Name of the Condition

• Nondisplaced osteochondral fracture of right patella

Summary

This condition involves a fracture of the right patella (kneecap) where a portion of the bone and its attached cartilage is damaged but remains in its normal anatomical position. The injury affects both the bony and cartilaginous structures, with the cartilage component distinguishing it from other patellar fractures. The nondisplaced nature indicates that the fracture fragments are not separated or misaligned.

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 fracture occurs when the force is sufficient to damage both the bone and overlying cartilage but not enough to displace the fragments.

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 right knee.
• Swelling and bruising around the kneecap.
• Inability to straighten or bear weight on the right knee.
• 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

• Immobilization with a brace or cast to allow healing.
• Pain management with medications or ice.
• Physical therapy to restore strength and mobility.
• Surgical intervention if the fracture is unstable or involves significant cartilage damage.

Prognosis and Follow-Up

Most nondisplaced fractures heal with conservative treatment, but recovery may take several weeks to months. Follow-up imaging and physical therapy are often recommended to monitor healing and restore function. Long-term outcomes depend on the extent of cartilage damage and adherence to rehabilitation.

Complications

• Post-traumatic arthritis due to cartilage injury.
• Chronic pain or stiffness in the knee.
• Reduced range of motion.
• Risk of future fractures if bone density is compromised.

Lifestyle & Prevention

• Use protective gear during high-risk activities.
• Maintain bone health through diet and exercise.
• Avoid sudden, forceful movements that strain the knee.
• Warm up properly before physical activity.

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 specific location (right patella), fracture type (nondisplaced), and involvement of both bone and cartilage. Ensure clinical notes specify the absence of displacement to support the code. Include details on trauma mechanism, imaging findings, and treatment approach for accurate coding.