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Patellar fracture after total knee arthroplasty
Cedric J Ortiguera1, Daniel J Berry
1Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905, USA. ortiguera.cedric@mayo.edu
The Journal of Bone and Joint Surgery. American Volume
|April 10, 2002
Summary
Patellar fractures after total knee arthroplasty are rare. Nonoperative treatment is often successful for stable fractures with an intact extensor mechanism, while operative treatment carries higher complication risks.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Musculoskeletal Research
Background:
- Patellar fractures are a known complication following total knee arthroplasty (TKA).
- Evaluating treatment outcomes for these specific fractures is crucial for improving patient care.
Purpose of the Study:
- To assess the outcomes of various treatment methods for patellar fractures occurring after TKA.
- To analyze the results based on specific fracture classifications.
Main Methods:
- Retrospective review of 85 patellar fractures in 77 patients after 12,464 TKAs (1985-1998).
- Fractures classified by extensor mechanism integrity, patellar implant fixation, and bone stock quality.
- Mean follow-up of 3.6 years for 78 treated fractures.
Main Results:
- Prevalence of patellar fracture after TKA was 0.68%, significantly higher in men.
- Type I fractures (stable implant, intact extensor mechanism) mostly treated nonoperatively with success.
- Types II (extensor disruption) and III (loose component) fractures treated operatively showed higher complication and reoperation rates.
Conclusions:
- Patellar fractures post-TKA are infrequent but require careful management.
- Treatment decisions should be guided by fracture type: nonoperative for stable Type I, operative consideration for Types II and III.
- Operative interventions for complex patellar fractures are associated with increased complications.