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Related Concept Videos

Bones of the Lower Limb: Femur and Patella01:16

Bones of the Lower Limb: Femur and Patella

The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the neck...
Knee Joint01:23

Knee Joint

The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris group...

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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Patella fracture after post total knee replacements.

E Michael Keating1, Gail Haas, John B Meding

  • 1Center for Hip and Knee Surgery, St. Francis Hospitals-Mooresville, IN 46158, USA. emkeating@att.net

Clinical Orthopaedics and Related Research
|December 4, 2003
PubMed
Summary

Patella fractures after total knee replacement (TKR) occur in 3.8% of cases. Nonoperative treatment generally yields good outcomes, while surgical intervention for these patella fractures leads to high complication rates.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Clinical Research

Background:

  • Patella fractures are a potential complication following total knee replacement (TKR).
  • Understanding the incidence and outcomes of these fractures is crucial for patient management.
  • Previous literature may not fully capture the spectrum of patella fracture types and their treatment sequelae post-TKR.

Purpose of the Study:

  • To determine the incidence, clinical function, and treatment complications of patella fractures occurring after total knee replacement (TKR).
  • To classify patella fractures based on extensor mechanism integrity and component fixation.
  • To compare outcomes between operative and nonoperative management strategies for patella fractures post-TKR.

Main Methods:

  • Retrospective study of 4583 primary total knee replacements (TKRs) performed between 1983 and 1996.
  • Identification and classification of 177 patella fractures in 135 patients.
  • Analysis of fracture types (vertical, extensor mechanism disruption, loose component) and treatment approaches (nonoperative vs. operative).

Main Results:

  • The incidence of patella fractures after TKR was 3.8% (177 fractures in 135 patients).
  • Nonoperative management typically resulted in no extensor lag and adequate pain and function.
  • Operative treatments, including patella button excision and open reduction internal fixation (ORIF), were associated with high complication rates such as deep infection and nonunion.

Conclusions:

  • Patella fractures represent a significant complication after total knee replacement (TKR).
  • Nonoperative management appears to be a safer approach with favorable functional outcomes.
  • Surgical intervention for patella fractures post-TKR carries a high risk of complications and should be avoided when possible.