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ISSN 打印: 1050-6934

ISSN 在线: 1940-4379

SJR: 0.184 SNIP: 0.485 CiteScore™:: 1.1 H-Index: 39

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Patellar Fractures Following Total Knee Arthroplasty: A Review

卷 23, 册 4, 2013, pp. 331-336
DOI: 10.1615/JLongTermEffMedImplants.2013010099
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摘要

There are several periprosthetic complications associated with total knee arthroplasty, with femoral fracture as the most common and patellar fractures as the second most common. Patellar fractures are challenging complications that occur almost exclusively on the resurfaced patellae, although unresurfaced patellar fractures have been reported in literature. The purpose of this study is to describe the anatomy of the patella, the etiology of patellar fractures, and strategies to treat and manage these fractures following knee arthroplasty. The vascular supply to the patella may be compromised during total knee arthroplasty and special care must be taken to preserve it. Vessel injury may result in further complications, most notably avascular necrosis with subsequent fracture. Other patient-, surgical-, and prosthetic-related factors can contribute to increased risk of patellar fracture. Patellar fractures are classified into three types. Type I fractures have an intact extensor mechanism with a stable implant. Type II fractures have a complete disruption of the extensor mechanism with or without a stable implant. Type III fractures, which are further subclassified into types IIIa and IIIb, have an intact extensor mechanism but a loose patellar component. While type IIIa fractures have reasonable remaining bone stock, type IIIb fractures have poor bone stock. Type I patellar fractures may be best managed nonoperatively, but types II and III patellar fractures often necessitate surgical intervention. Patellectomy should be reserved for comminuted fractures, as well as fractures in patients with poor bone stock. Larger prospective randomized studies are necessary to better evaluate the treatment algorithm for patellar fractures following total knee arthroplasty.

对本文的引用
  1. Cho Yau Lo, Tun Hing Lui, Kit NT Sit Yan, Split Fracture: A Complication of Cerclage Wiring of Acute Patellar Fracture, Archives of Trauma Research, 3, 3, 2014. Crossref

  2. King Alexander H., Engasser William M., Sousa Paul L., Arendt Elizabeth A., Dahm Diane L., Patellar Fracture Following Patellofemoral Arthroplasty, The Journal of Arthroplasty, 30, 7, 2015. Crossref

  3. Kloiber J., Goldenitsch E., Ritschl P., Patellarekonstruktion bei defizientem knöchernen Lager, Der Orthopäde, 45, 5, 2016. Crossref

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  5. Assiotis Angelos, To Kendrick, Morgan-Jones Rhidian, Pengas Ioannis P., Khan Wasim, Patellar complications following total knee arthroplasty: a review of the current literature, European Journal of Orthopaedic Surgery & Traumatology, 29, 8, 2019. Crossref

  6. Zywiel Michael G., Gandhi Rajiv, Mahomed Nizar N., Patellar Resurfacing in Total Knee Arthroplasty, in Evidence‐Based Orthopedics, 2021. Crossref

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