title: Case report: the nest technique for management of a periprosthetic patellar fracture with severe bone loss.
abstract: Periprosthetic patellar fracture with marked loss of bone stock presents a significant problem in total knee arthroplasty. Treatment outcomes are often unsatisfying and may lead to disruption of the extensor mechanism of the knee. We present a patient with a Type IIIb periprosthetic patellar fracture treated by a novel approach. Three Steinmann pins were used to reduce the patella and form scaffold for bone graft and a patellar button was cemented into the construct. At 7 years followup, the patient has maintained excellent range of motion, reports no knee pain, has healed the patella fracture, and has restored patellar bone stock.
authors.affiliation: Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Anderson
authors.forename: David J
authors.initials: DJ
authors.lastname: Polga
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Ryssman
authors.forename: Robert T
authors.initials: RT
authors.lastname: Trousdale
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods*; D001858:Bone Nails; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D010329:Patella / Q000293:injuries* / Q000601:surgery*; D012086:Reoperation / Q000009:adverse effects / Q000379:methods; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous