A study of the long-term effects of anatomical open reduction of patella on patellofemoral articular cartilage in follow up arthroscopy

Anatomical open reduction is the choice treatment method in patellar fractures and the sole approach to study the cartilage surface healing is arthroscopy. This study is to evaluate the cartilage healing, long after the complete union of the fractures and the long-term effects of simple transverse patellar fractures with perfect results on patellofemoral cartilage surface. Free of charge standard diagnostic arthroscopy was done on 22 patients whose simple transverse pattelar fractures had happened at least 3 years ago with the mean age of 36.4 years. Fractures had happened at least 3 years ago and all cases had excellent union results. The data collected from cartilage surface studies were recorded. No other statistical tests were used except for X2 test to study the relation between clinical and radiological findings and arthroscopies. The elapsed time from the fracture occurrence to the arthroscopy was 39.2 months, at least 36 months. Five patients (22.6%) showed complete cartilage healing in cartilage surface arthroscopy and 10 patients (45.2%) proved to have Grade I chondral lesions. Four patients had Grade II chondral lesions and 3 patients had Grade III chondral lesions along with fibrillation. In 2 patients mirror cartilage lesions were observed in the opposite trochlea. In 3 patients with normal radiological signs, step-off was observed on cartilage surface. There was no relation between clinical signs and radiological characteristics of the patients with the healing on cartilage surface (p = 0.84). Having a diagnostic arthroscopy in an appropriate time after fusion, especially during extracting the metal instrument, is effective on evaluating patient's prognosis. Extracting metal instruments along with the simultaneous chondroplasty has low cost and complications, though leading to a decrease in the prevalence of secondary osteoarthritis and probably the eruptive swelling due to the debris released from probable fibrillations.