Periprosthetic patellar fractures


Parvizi J., Kim K., Oliashirazi A., Ong A., Sharkey P. F.

CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, cilt.446, sa.446, ss.161-166, 2006 (SCI-Expanded) identifier identifier identifier identifier

Özet

Patellar fracture after total knee arthroplasty is a rare yet challenging complication. Patellar fracture can occur as a result of trauma or it may be atraumatic. A multitude of factors can lead to periprosthetic patellar fracture including patient related factors, surgical technique related factors, and implant specific factors. Understanding the etiologic factors leading to atraumatic patellar fractures could result in minimizing complications. We present the results of periprosthetic patellar fractures in 12 patients. All type 1 nondisplaced fractures (7 cases) were treated nonoperatively. Surgical treatment was selected for the remaining 5 cases which included resection arthroplasty combined with open reduction and internal fixation of the fracture (3 knees), partial patellectomy (I knee), and total patellectomy (1 knee). The outcome was excellent in 1 knee, good in 8 knees, and fair in the remaining 3 knees at the latest follow-up. There were 2 reoperations; 1 for disruption of the extensor mechanism and 1 for refracture. One patient developed a superficial wound infection. We reviewed the available literature regarding the etiology, surgical strategies, and outcomes for periprosthetic patellar fracture.