Arthroscopic-assisted Suture-based Fixation of Patellar Osteochondral Fractures using the DG-lock Suturing: A Novel Technique

Introduction: Patellar osteochondral fractures (OCFs) commonly occur following acute lateral patellar dislocation and have traditionally been managed using metallic or bioabsorbable implants, which may abrade cartilage or require later removal. This case demonstrates an alternative management in the form of an arthroscopic-assisted suture-based fixation of patellar OCFs using the DG-lock suturing. Case Report: A 17-year-old male who presented to our facility with pain and deformity of the knee following a self-fall. On examination, tenderness was present over the medial aspect. On Radiographic imaging findings were suggestive of inferomedial patellar OCF. After meticulous planning, the patient underwent arthroscopy-assisted reduction and suture-based fixation using the DG-lock suturing technique.Arthroscopy allowed identification of the avulsed fragment, which was displaced and adherent to the lateral femoral condyle within a hematoma. After arthroscopic localization and mobilization, the fragment was fixed using multiple high-strength suture loops through transosseous patellar tunnels, providing broad compression without articular hardware.Early range of motion and full weight-bearing in a hinged brace were initiated post-operatively, resulting in radiographic union and return to activity by 10-12 weeks. Post-operative outcomes of DG-lock suturing demonstrated favorable results compared to conventional methods, such as the standard metallic and bioabsorbable implants used for OCF management. Conclusion: Arthroscopy-assisted DG-lock suture fixation offers a minimally invasive, hardware-free method for managing patellar OCFs. It provides fragment-preserving compression, reduces soft-tissue trauma, and enables early rehabilitation, making it a viable and novel alternative to metallic implants.