(Fig 4-A.28) Displaced Osteochondral Fragments

https://youtu.be/3kU5K3IAhR4

https://youtu.be/vzxclU_34OI?si=B88NykUJHSELzyAC

 

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📌Acute Patellar Dislocation and Loose Bodies

 

• After an acute patellar dislocation, it's crucial to search for loose chondral or osteochondral fragments throughout the joint. 
• These fragments often hide in specific knee recesses.

 

✅ Knee Recesses for Loose Bodies

• Sub-popliteus Recess: Located between the popliteus tendon and the posterior horn of the lateral meniscus.
• Posterior Capsular Recess: Found behind the PCL, extending from the medial femorotibial compartment.
• Suprahoffatic Recess: At the superior part of Hoffa’s fat pad, near the inferior border of the patella.
• Infrahoffatic Recess: Anterior to the lower portion of the infrapatellar plica (ligamentum mucosum).
• Posterior Femoral Recesses (Subgastrocnemius Recesses): Behind the femoral condyles and gastrocnemius muscle heads.
• Anterior Tibial Recess: Immediately anterior to the proximal tibia.
• Central Synovial Recess: Between the patella/patellar ligaments and the anterior femur.
• Parameniscal Recess: Above and below the lateral meniscus, in contact with the lateral femoral and tibial condyle.

 

✅ Characteristics of Loose Bodies

• Fresh Chondral Loose Bodies: Retain the normal structure of articular cartilage.
• Long-standing Chondral Bodies: Enlarge, become rounded, and may either float freely or embed in the synovial lining.
• Osteochondral Loose Bodies: Show cartilage along with a piece of subchondral bone plate on imaging.

References

1. Clin Sports Med. 2014 Jul;33(3):413-36.
2. Semin Musculoskelet Radiol. 2021 Oct;25(5):690-699.
3. Insights Imaging (2013) 4:257–272.

 

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#PatellarDislocation, #KneeRecesses, #OsteochondralLooseBodies, #ChondralLooseBodies, #HoffasFatPad, #MRI, #KneeAnatomy, #Orthopedics, #Radiology, #SportsMedicine