[Patellectomy after trauma: is there a correlation between the timing and the clinical outcome]

Is there a correlation between the timing of patellectomy after trauma in crush injuries and the clinical outcome?

Retrospective analysis of 21 patients who had undergone patellectomy after trauma.

In 12 patients (57.1%) a primary patellectomy was performed within 4 weeks after the fracture; in the remaining 9 (42.9%) patients the procedure was performed after an average of 21 months (range 2-72). Nineteen patients could be followed up after 9.3 years (range 3-18). In 10 of these, patellectomy had been performed primarily. The HSS Knee Score was 68.4 points (range 39-83) on average for all patients. For patients with a primary patellectomy the score was 71 points (range 54-83), while for patients in whom the patellectomy was performed secondarily the score was 63.8 points (range 39-77). The evaluated ROM was 113.6 degrees for all patients; in the primary group ROM was 122.5 degrees (range 65-145 degrees ), and in the secondary group it was 103 degrees (range 85-145 degrees ). The difference was not statistically significant for either parameter.

Primary reconstruction of the patella is recommended in multifragmentary fractures; if the outcome is poor, however, patellectomy should be considered early.