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Chondral fractures of the knee

Cause for confusion

Orthopaedic Service, Keller U.S. Army Hospital, United States Military Academy, West Point, New York

William A. Mitchell, MD

Orthopaedic Service, Keller U.S. Army Hospital, United States Military Academy, West Point, New York

Walton W. Curl, MD

Orthopaedic Service, Keller U.S. Army Hospital, United States Military Academy, West Point, New York

Knee pain in the athlete can pose difficulty in diagnosis. At the United States Military Academy at West Point we have had occasion to see a group of patients presenting with meniscal symptoms of locking, catch ing, giving way, and joint line tenderness who, on arthroscopic examination, have chondral fractures of the medial or lateral femoral condyle. These individuals have undergone arthroscopy and debridement of the chondral defect.

Both retrospectively and prospectively we have been unable to find any defects on radiographs and there appears to be purely cartilaginous involvement. These individuals appear to have a relatively poor prognosis for recovery after arthroscopy. Treatment has been a standard course of range of motion exercises, strengthening, and antiinflammatory medications. How ever, the mean rehabilitation time has been almost triple the time associated with a routine meniscal injury.

We feel that it is important to discuss the chondral fracture so that the orthopaedic surgeon can be aware of this possibility in the differential diagnosis of knee pain in the athlete.

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