title: Fix it or discard it? A retrospective analysis of functional outcomes after surgically treated patella fractures comparing ORIF with partial patellectomy.
abstract: OBJECTIVE
  The goal of this study was to compare functional outcomes of patients with patella fractures treated with open reduction and internal fixation (ORIF) with those treated with partial patellectomy (PP).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Urban Level I Trauma Center.
  
  
  METHODS
  Seventy-three patients with isolated displaced patella fractures underwent operative treatment between January 1, 2002, and December 31, 2009, at our institution. Of these, 52 (71%) patients with isolated patella fractures with minimum 1-year follow-up agreed to participate and were enrolled in the study.
  
  
  METHODS
  PP or ORIF.
  
  
  METHODS
  Patients completed outcome questionnaires and participated in a physical examination. Outcome instruments included the Knee Outcome Survey-Activities of Daily Living Scale, Short Form (SF)-36 Health Survey, and SF Musculoskeletal Function Assessment Survey.
  
  
  RESULTS
  Twenty-six patients underwent PP and 26 underwent ORIF. There were no significant differences in any of the functional outcome instruments, including Knee Outcome Survey-Activities of Daily Living Scale (ORIF: 64.1 ± 11, PP: 62.1 ± 7.9, P = 0.76), SF-36 physical component score (ORIF: 40.8 ± 5.4, PP: 41.1 ± 5.2, P = 0.94), SF-36 mental component (ORIF: 47.7 ± 5.1, PP: 51.8 ± 4.9, P = 0.19), Short Musculoskeletal Function Assessment (SMFA) Function Index (ORIF: 28.6 ± 9.1, PP: 27.7 ± 6.7, P = 0.78), or SMFA Bother Index (ORIF: 26.0 ± 9.7, PP: 23.6 ± 8.8, P = 0.72). Complication rates did not differ significantly between the 2 groups.
  
  
  CONCLUSIONS
  This study demonstrates that functional impairment persists after operative treatment of patella fractures. Both ORIF and PP demonstrated similar final range of motion, functional scores, and complication rates. Despite its purported benefits, in this study, ORIF did not result in superior outcomes compared with PP.
  
  
  METHODS
  Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors: Department of Orthopaedic Surgery, University of Cincinnati Medical Center, Cincinnati, OH.
authors: Nicolas S
authors: NS
authors: Bonnaig
authors: Chris
authors: C
authors: Casstevens
authors: Michael T
authors: MT
authors: Archdeacon
authors: Camille
authors: C
authors: Connelly
authors: Nathan
authors: N
authors: Monaco
authors: John D
authors: JD
authors: Wyrick
authors: Theodore T
authors: TT
authors: Le
mesh_terms: D000328:Adult; D005260:Female; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D010329:Patella / Q000293:injuries / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome