Q: After having a dislocation of the kneecap my knee locked into place and would not move. An X-ray at the Emergency Department showed an 'osteochondral Fracture'. What is it ? A: An osteochondral fracture is a small piece of bone or cartilage that is sheared off the inside surface of the knee. This bone chip may float around in the knee joint, and if it gets in between the two bones as they pass over one another, it may cause the knee to "lock". It usually occurs due to another injury of the knee, such as patellar dislocation or ligament injury, that allows the thigh bone (femur) to collide with the shin bone (tibia) in some unnatural way.

Q: Are osteochondral fractures always seen on X-Ray?

A: Osteochondral fractures are inconsistently seen on X-Ray. That is, although they may be seen on X-Ray films, but they also may not be seen. In general, if the symptoms are present, and the examination by a skilled physician is consistent with the injury, then osteochondral fracture is probably present, even if not seen on X-Ray.

If necessary, an Arthroscopy, to look directly inside the knee with a video camera, may help to prove a fracture is present.

Q: Will my osteochondral fracture require surgery, or will the pain and swelling go away on their own ?

A: The pain and swelling that occurs shortly after the initial injury will almost certainly subside with rest, ice, and possibly some mild physiotherapy.

However, treatment of the fracture itself varies form person to person. Larger fractures are often treated by re-attaching the fragment under arthroscopic (video) guidance.

Smaller fractures are often treated by simply watching to see what happens. If the knee continues to lock frequently, then treatment may be necessary. This may include removing the small piece of bone by arthroscope. However if the knee never locks, or does so only rarely, the person may elect to live with it, and not proceed to surgery.