Internal fixation of a traumatic osteochondral defect presents a challenge in terms of obtaining anatomic reduction, fixation,
and adequate compression for healing. Fixation with countersunk intraarticular screws, Herbert screws, bioabsorbable screws
and pins, mini-cancellous screws, and glue tissue adhesive have been reported with varying results. We present an alternative
fixation method used in two patients for femoral condylar defects that achieved anatomic reduction with compression via a
cruciate-shaped suture bridge construct tied down over a bony bridge. This fixation method allowed early passive range of
motion and permitted high-quality MRI for followup of fracture healing and articular cartilage integrity. Arthroscopic examination
of one of two patients at 6 months followup showed the gross appearance of a healed, anatomically reduced fracture. With 1 year
followup for one patient and 2 years for the other, the patients have resumed activity as tolerated with full, painless range
of motion at the knee. Longer-term outcomes are unknown. However, the suture bridge is an alternative means of fixation with
encouraging early results for treatment of traumatic osteochondral fragments in the knee.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation,
that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation
in the study was obtained.