title: Fracture of the patella after the anterior cruciate ligament reconstruction.
abstract: BACKGROUND
  Fracture of the patella, after harvesting the central third of the patellar tendon for a bone-tendon-bone autograft, is a rare complication.
  
  
  METHODS
  We made 1714 reconstructions of the anterior cruciate ligament of the knee using bone-patellar tendon-bone technique, and 7 patients had fracture of the patella (0.42%). The fracture was immediately recognized in the patients with vertical non-displaced patellar fracture and the broken screw osteosynthesis was carried out without changes in the rehabilitation period. One patient was treated non-operatively and patellar fracture in four patients was treated with operative reduction and osteosynthesis.
  
  
  RESULTS
  The patients were invited for the check-up 5 years (2-8 years) after surgery on average. The mean Lysholm score was 92 (85-100). All of them continued to engage in sporting activities at the same or greater level after 9 months on average (6-12 months). In all patients the Lachman test was with the firm stop compared to the other leg. X-ray changes in the patella were found in 2 patients who had multifragmentary fractures.
  
  
  CONCLUSIONS
  The fracture of patella can be prevented by avoiding to take too much bone graft, by using the most precise tools for cutting, while rehabilitation must be carefully planned. The optimal treatment of the fracture of the patella after the reconstruction of the anterior cruciate ligament is a firm osteosynthesis, which allows healing of the bone and continuation of the rehabilitation program.
authors.affiliation: Clinical Centre of Vojvodina, Department of Orthopaedic Surgery and Traumatology, University of Novi Sad, Faculty of Medicine, Novi Sad. milankom@eunet.rs
authors.forename: Miroslav
authors.initials: M
authors.lastname: Milankov
authors.forename: Predrag
authors.initials: P
authors.lastname: Rasović
authors.forename: Nemanja
authors.initials: N
authors.lastname: Kovacev
authors.forename: Milan
authors.initials: M
authors.lastname: Milović
authors.forename: Veselin
authors.initials: V
authors.lastname: Bojat
mesh_terms: D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects* / Q000379:methods; D050376:Bone-Patellar Tendon-Bone Grafting / Q000009:adverse effects*; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D010329:Patella / Q000000981:diagnostic imaging / Q000293:injuries*; D011183:Postoperative Complications; D011859:Radiography; D055815:Young Adult