Regional anesthesia for patella fracture repair: a retrospective study on safety and efficacy

The purpose of this study was to evaluate the short-term postoperative outcomes of patients undergoing patella open reduction internal fixation procedures based on the type of anesthesia administered.

A retrospective review was conducted of patients who were surgically treated for displaced patella fractures from 2012 to 2024 at a single multi-site academic institution. Patients were included if they were > 18 years of age, sustained an isolated patella fracture, and had a minimum of 6-month follow-up. Patients were divided into groups based on the anesthetic modality used during their surgery: regional anesthesia only (RA), general/neuraxial anesthesia (NR), and a combination of these methods (CA). Comparisons of statistics were performed using Pearson chi-squared tests, one-way ANOVA tests, and linear regression tests as appropriate.

There were no complications associated with the administration of anesthesia within each cohort. There was no significant difference in fracture healing rates (p = .210) nor complication rates between the anesthesia groups (p = .088). The RA and CA groups had significantly shorter operating room (wheels in to wheels out) times than the NR group (p < .001), significantly greater 3-month (p = .001) and 6-month knee ROM (p = .016) than the NR group when controlling for age, fracture pattern, and repair method.

This study demonstrates the efficacy of the use of regional anesthesia only for repair of a patella fracture. This technique is associated with greater early range of knee motion in patients after surgery and a shorter surgical time with no increase in intra or postoperative complications.