Periprosthetic Patellar Fractures

Sheth, Neil P.; Pedowitz, David I.; Lonner, Jess H.

doi:10.2106/jbjs.g.00132

Cited by 43 publications

(66 citation statements)

References 26 publications

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“…Patellar periprosthetic fracture has been reported very rare and the incidence after total knee arthroplasty is about 0.5% to 3% (5). There has been no report of periprosthetic patellar fracture around tumor endoprosthesis; we reported a particular case of periprosthetic patellar fracture around knee tumor enoprosthesis in a 60-year-old female with a previous history of distal femoral giant cell tumor.…”

Section: Introductionmentioning

confidence: 78%

Open Periprosthetic Patella Fracture Around Knee Endoprosthesis: A Unique Case Report

Mortazavi¹,

Kalantar²,

Firoozabadi³

et al. 2017

J Orthop Spine Trauma

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Introduction: Periprosthetic fracture, after total knee arthroplasty, is one of the most common reasons of revision arthroplasty and periprosthetic fracture of the patella has been shown to be very rare. Literature review has shown no reports of periproshtetic fracture of the patella around tumor endoprosthesis. Only 1 study has discussed management of open periprosthetic fractures of the patella as this type of fracture is extremely rare. Case Presentation: We report a particular open periprosthetic fracture of the patella around a tumor endoprosthesis in a 60 years old female, that was treated with irrigation and debridement and tension band wiring and 3 month of follow up showed satisfactory range of motion with no extension lag. Conclusions: Despite the fact that operative management of periprosthetic fractures of the patella has a high rate of complications and poor outcome, it can be considered for patients with open periprosthetic fractures of the patella, especially when the extensor mechanism is compromised.

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Section: Introductionmentioning

confidence: 78%

Open Periprosthetic Patella Fracture Around Knee Endoprosthesis: A Unique Case Report

Mortazavi¹,

Kalantar²,

Firoozabadi³

et al. 2017

J Orthop Spine Trauma

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“…Für Frakturen vom Typ II oder III B kann die Patellektomie die einzige Option sein [38]. Bei Typ-IIIB-Frakturen führt die chirurgische Behandlung zu guten bis befriedigenden und die konservative Behandlung meist zu schlechten Ergebnissen.…”

Section: Operative Therapieunclassified

“…Es sollte zunächst eine Rekonstruktion des Streckapparates erfolgen, die Reimplantation folgt in einem zweiten Schritt [3,4,12]. Feste Komponenten werden nur dann entfernt, wenn die Stabilisierung der Fraktur dies erfordert [38]. Frakturen des proximalen oder des distalen Pols werden versorgt wie beim gesunden Knie, und, falls erforderlich, mit Autograft oder Allograft augmentiert.…”

Section: » Frakturen Bei Entfernung Eines Festen Rückflächenersatzes unclassified

“…Sheth et al [38] berichteten über eine Prävalenz von 0,9-21 % bei unterschiedlichen Autoren, wobei Unterschiede zwischen primärer und Revisionsendoprothetik, Verwendung von zementieren oder zementfreien Implantaten sowie eingesetztem oder nicht verwendetem retropatellarem Gelenkersatz bestanden. Bei den publizierten Daten fand sich eine große Variabilität von Faktoren, die letztendlich alle unabhängig voneinander die Prävalenz und das Muster der Frakturen beeinflussen können.…”

Section: Introductionunclassified

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Patellafrakturen in der Knieendoprothetik

2016

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Periprosthetic patella fractures occur both with and without retropatellar joint replacement. A non-operative treatment yields satisfactory results with low morbidity. It can be applied in minimally displaced fractures that have an intact retropatellar component and an intact extensor mechanism, combined with an initial immobilization. The surgical treatment is associated with relatively poor results and with high complication rates. There was only minor improvement of functional results, no matter which surgical technique was used. Surgical intervention is still required in fractures with a loosening of the patellar component, considerable dislocations of fragments, and damage to or rupture of the extensor mechanism. In particular, type II fractures require repair of the extensor mechanism and the fracture or patellectomy. Type III fractures require a revision or resection of the patella, a patelloplasty or total patellectomy. In addition, early or late reconstruction using allograft to restore the extensor mechanism can be taken in consideration.

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“…In cases with a stable implant and no disruption to the extensor mechanism, nonoperative management, with a short period of immobilisation, produces acceptable results in the majority a b of cases [ 49 ]. In cases with disruption of the extensor mechanism, reconstruction of the extensor mechanism with partial patellectomy (if necessary) is recommended above cerclage or tension band wiring, which has a high rate of treatment failure [ 10 ].…”

Section: Periprosthetic Patellar Fracturesmentioning

confidence: 99%