[Patella fractures in knee arthroplasty]

Area of Science:

• Orthopedic surgery
• Biomedical engineering

Background:

• Periprosthetic patella fractures can occur with or without retropatellar joint replacement.
• These fractures present unique challenges in management and treatment outcomes.

Purpose of the Study:

• To evaluate the outcomes of operative versus non-operative management for periprosthetic patella fractures.
• To identify optimal treatment strategies based on fracture characteristics and extensor mechanism integrity.

Main Methods:

• Review of non-operative treatment for minimally displaced fractures with intact components and extensor mechanism.
• Analysis of surgical outcomes for complex fractures requiring intervention.
• Categorization of treatment based on fracture types (II and III) and component status.

Main Results:

• Non-operative treatment yields satisfactory results with low morbidity for select fractures.
• Surgical treatment is associated with poor results and high complication rates.
• Functional improvement is minimal regardless of surgical technique, reserved for component loosening, dislocations, or extensor mechanism compromise.

Conclusions:

• Non-operative management is effective for minimally displaced periprosthetic patella fractures.
• Surgical intervention is necessary for unstable fractures but carries significant risks and limited functional gains.
• Specific surgical approaches are indicated for different fracture types, including potential allograft reconstruction for the extensor mechanism.