Current concepts review: Fractures of the patella

Gwinner, Clemens; Märdian, Sven; Schwabe, Philipp; Schaser, K.-D.; Krapohl, Björn Dirk; Jung, Tobias

doi:10.3205/iprs000080

Cited by 61 publications

(50 citation statements)

References 77 publications

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“…Based on the mechanism of injury, considerable variations exist in the morphology of patella fractures. These fractures can be described using the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification system or according to the geometric configuration of fracture lines, which includes osteochondral, marginal, stellate, and linear patterns [ 48 ]. While pole avulsion injuries and transversely linear fractures are often due to rapid eccentric loading of the extensor mechanism, direct impact injuries more frequently result in comminuted or stellate-type fractures with 65% of these injuries being nondisplaced [ 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

Patella Strength Characteristics in Cemented vs Press-fit Implants: A Biomechanical Analysis of Initial Stability

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Patella Strength Characteristics in Cemented vs Press-fit Implants: A Biomechanical Analysis of Initial Stability

et al. 2022

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“…As aforementioned, surgical excision of the fracture fragment avoids the common complications associated with patella fixation. Most notably, symptomatic hardware (10%–52%), decreased range of movement of knee flexion (26%–38%), anterior knee pain (28%–50%), loss of reduction (4.7%–22%), delayed or non-union (2.7%–12.5%), infection (2%–10%) and patellofemoral osteoarthritis (8.5%–39%) 13 14. The complication risk increases in the case of bilateral patellar fractures 15 16.…”

Section: Discussionmentioning

confidence: 99%

Surgical excision of bilateral patella stress fractures in an elite marathon runner

et al. 2022

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Vertical stress fractures of the patella are rare, with only a handful of bilateral cases reported. Stress fractures in the athletic community are often due to repetitive strain and submaximal loading, with minimal recovery time. An Olympic marathon runner in her 30s presented with right anterolateral knee pain. MRI revealed an acutely displaced vertical fracture of the lateral patella. After failure of non-operative treatment, she underwent surgical excision of the fracture fragment and lateral patellofemoral retinacular repair. Despite return to light training pain-free 3 weeks after surgery, she presented 2 months later with a contralateral vertical patella stress fracture. On this occasion, early operative treatment was performed with early return to training and resolution of symptoms.This is the first reported case of bilateral vertical patellar stress fractures in an athlete treated with excision of the fracture fragment. This is an excellent option for elite athletes who require a quick postoperative recovery, complete resolution of symptoms and early return to preinjury level of sport.

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“…9,11 in humans, stable non-displaced fractures (less than 2 mm of dislo cation) are considered suitable for a conservative approach. 21 Before conservative treatment is instigated in humans, it is recommended that cases are tested (using fluoroscopic imaging) under 60° of knee flexion in order to confirm a stable situation with no tendency for displacement. 21 in cats, both fractures that are nondisplaced and those that are significantly displaced have been treated conservatively, with animals regaining good function in both scenarios.…”

Section: Options For Managing Patellar Fractures In Catsmentioning

confidence: 99%

Patellar fractures in cats: Repair techniques and treatment decision-making

Langley‐Hobbs

2021

Journal of Feline Medicine and Surgery

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Practical relevance: While feline patellar fractures are not commonly encountered in practice, they tend to be found more often in younger cats; no breed or sex predispositions are recognised. If there is no evidence of a traumatic aetiology, the cat may be suspected of having patellar fracture and dental anomaly syndrome (PADS). Patellar fractures are easy to diagnose on lateral radiographs and there are several different fracture types. The type of fracture, the age of the cat at fracture occurrence and whether there is suspicion of a pathological aetiology are all relevant when considering treatment technique. Clinical challenges: While some cats with patellar fractures will do well with conservative management, surgical treatment is often indicated and decision-making can be challenging. Evidence base: Information and recommendations provided in this review are based on the literature and the author’s own clinical experience. There are several publications on PADS, but there is limited evidence as to what the underlying cause of this condition is, and the best method for managing patellar fractures is still an area where more research is needed. Aim: This review aims to gather the papers, case series and case reports published over the past few decades in order to discuss how best to manage different types of patellar fractures.

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Current concepts review: Fractures of the patella

Cited by 61 publications

References 77 publications

Patella Strength Characteristics in Cemented vs Press-fit Implants: A Biomechanical Analysis of Initial Stability

Patella Strength Characteristics in Cemented vs Press-fit Implants: A Biomechanical Analysis of Initial Stability

Surgical excision of bilateral patella stress fractures in an elite marathon runner

Patellar fractures in cats: Repair techniques and treatment decision-making

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