title: Patella fracture after post total knee replacements.
abstract: A retrospective study was done to determine the incidence, clinical function, and complications of treatment in a large series of patella fractures after total knee replacement (TKR). Between 1983 and 1996, 4583 primary AGC TKRs done at our institution. One hundred seventy-seven fractures were identified in 135 patients for a fracture incidence of 3.8%. Twenty-two fractures were vertical and had a stable implant and intact extension mechanism (Type 1). Twenty-one fractures had disruption of the extensor mechanism of less than 1 cm (Type 2A). Seventeen fractures had disruption of the extensor mechanism of 1 cm or more (Type 2B). One hundred fourteen fractures had a loose component and an intact extension mechanism (Type 3). Patients treated nonoperatively generally had no extensor lag and had adequate pain and function scores. Patients treated operatively had a high complication rate. Four of nine patients treated with excision of an extruded patella button developed a deep infection. Both patients treated with open reduction internal fixation (ORIF)had a nonunion develop. Surgery on patients with patella fractures has a high complication rate and should be avoided if possible.
authors.affiliation: Center for Hip and Knee Surgery, St. Francis Hospitals-Mooresville, IN 46158, USA. emkeating@att.net
authors.forename: E Michael
authors.initials: EM
authors.lastname: Keating
authors.forename: Gail
authors.initials: G
authors.lastname: Haas
authors.forename: John B
authors.initials: JB
authors.lastname: Meding
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D016009:Chi-Square Distribution; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies