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Updated: Jun 3, 2026

Knee Arthrocentesis in Adults

Knee Arthrocentesis in Adults

Published on: February 25, 2022

Patellar fractures in adults.

J Stuart Melvin¹, Samir Mehta

¹Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.

The Journal of the American Academy of Orthopaedic Surgeons

|April 6, 2011

Summary

Patellar fractures, common knee injuries, require surgery if displaced or disrupting the extensor mechanism. Optimal outcomes for patellar fractures involve anatomical reduction and tension-band fixation, though hardware complications can occur.

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Last Updated: Jun 3, 2026

Knee Arthrocentesis in Adults

Knee Arthrocentesis in Adults

Published on: February 25, 2022

Area of Science:

Orthopedic Surgery
Traumatology
Biomechanics

Background:

Patellar fractures are frequent injuries resulting from extensor mechanism tension or direct trauma.
The patella is crucial for knee extensor function and articulation.
Fractures can cause significant long-term issues like stiffness, weakness, and arthritis.

Purpose of the Study:

To review current management strategies for patellar fractures.
To outline indications for surgical versus nonsurgical treatment.
To discuss optimal surgical techniques and potential complications.

Main Methods:

Review of literature on patellar fracture management.
Analysis of treatment outcomes based on fracture displacement and extensor mechanism integrity.
Evaluation of surgical techniques, including tension-band fixation.
Assessment of complications associated with open versus closed fractures.

Main Results:

Nondisplaced fractures with intact extensor mechanisms are managed non-surgically.
Surgical fixation is indicated for displaced fractures (>2-3 mm step-off or >1-4 mm displacement) or disrupted extensor mechanisms.
Tension-band fixation offers the best outcomes for surgical repair.
Symptomatic hardware is a common complication after fixation.
Open patellar fractures have higher complication rates, manageable with prompt surgical intervention.

Conclusions:

Treatment decisions for patellar fractures depend on displacement and extensor mechanism status.
Anatomical reduction and stable fixation, particularly tension-band wiring, are key for favorable outcomes.
Awareness and management of potential complications, such as hardware irritation and infection in open fractures, are essential.