Non-metallic implant for patellar fracture fixation: A systematic review.
BACKGROUND
Despite good clinical outcome proposals, there has been relatively little published regarding the use of non-metallic implant for patellar fracture fixation. The purpose of the study was to perform a systematic literature review to summarize and evaluate the clinical studies that described techniques for treating patella fractures using non-metallic implants.


METHODS
A comprehensive literature search was systematically performed to evaluate all studies included in the literature until November 2015. The following search terms were used: patellar fracture, patella suture, patella absorbable, patella screw, patella cerclage. Two investigators independently reviewed all abstracts and the selection of these abstracts was then performed based on inclusion and/or exclusion criteria.


RESULTS
A total of 9 studies involving 123 patients were included. Patients had a mean age of 33.7 years and were followed up for a mean of 18.9 months. The most common method for fracture fixations included the use of suture material. Good clinical outcomes were reported among all studies. Thirteen patients (10.5%) presented complications, while 4 patients (3.2%) required additional surgery for implant removal.


CONCLUSIONS
There is a paucity of literature focused on the use of non-metallic implant for patellar fracture fixation. However, this systematic review showed that non-metallic implants are able to deliver good clinical outcomes reducing the rate of surgical complications and re-operation. These results may assist surgeons in choosing to use alternative material such as sutures to incorporate into their routine practice or to consider it, in order to reduce the rate of re-operation.
Department of Orthopaedic Surgery, Università degli Studi di Palermo (DiChirOnS), Via del Vespro, Palermo, Italy. Electronic address: lawrence.camarda@unipa.it.
Lawrence
L
Camarda
Department of Orthopaedic Surgery, Università degli Studi di Palermo (DiChirOnS), Via del Vespro, Palermo, Italy.
Salvatore
S
Morello
Department of Orthopaedic Surgery, Università degli Studi di Palermo (DiChirOnS), Via del Vespro, Palermo, Italy.
Francesco
F
Balistreri
Department of Orthopaedic Surgery, Università degli Studi di Palermo (DiChirOnS), Via del Vespro, Palermo, Italy.
Antonio
A
D'Arienzo
Department of Orthopaedic Surgery, Università degli Studi di Palermo (DiChirOnS), Via del Vespro, Palermo, Italy.
Michele
M
D'Arienzo
D001672:Biocompatible Materials; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D017102:Fracture Healing; D050723:Fractures, Bone / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D007720:Knee Prosthesis; D010329:Patella / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome
D001672:Biocompatible Materials
FiberWire; Implant removal; Knee fracture; Non-metallic implant; Patellar fracture; Suture fixation; Tension band