From the Research
The treatment of impaction deformity of the lateral femoral condyle (LFC) should prioritize arthroscopic-assisted or open reduction with internal fixation (ORIF) to restore joint congruity and function, as supported by the most recent study 1. The primary approach depends on the severity and chronicity of the impaction. For acute injuries with significant depression, elevation of the impacted fragment followed by bone grafting (either autograft from the iliac crest or allograft) is recommended to provide structural support, as seen in a case report 2. Fixation is then achieved using headless compression screws, buttress plates, or bioabsorbable pins. Some key points to consider in the treatment of LFC impaction deformity include:
- The use of arthroscopic TWINFIX Ti suture anchor internal fixation, as described in a surgical technique report 3, which can provide good results in selected cases.
- The application of anchor absorbable sutures for osteochondral fracture of the lateral femoral condyle, as reported in a case study 4, which can be an effective and economical option.
- The importance of early intervention to prevent progressive joint incongruity, cartilage damage, and post-traumatic arthritis, as highlighted in a scoping review 1, which emphasizes the need for prompt treatment to improve outcomes. Post-operatively, patients should follow a progressive rehabilitation protocol with initial weight-bearing restrictions for 6-8 weeks, followed by gradual return to weight-bearing with physical therapy focusing on range of motion exercises, quadriceps strengthening, and proprioception training. For chronic cases with associated osteoarthritis, additional procedures such as osteochondral autograft transfer (OATs), autologous chondrocyte implantation (ACI), or in severe cases, unicompartmental or total knee arthroplasty may be necessary, as discussed in various studies 5, 1.