Parvizi Javad, Kim Kang-Il, Oliashirazi Ali, Ong Alvin, Sharkey Peter F
Rothman Institute of Orthopedics at Thomas Jefferson University, Philadelphia, PA 19107, USA.
Clin Orthop Relat Res. 2006 May;446:161-6. doi: 10.1097/01.blo.0000218722.83601.18.
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 peri-prosthetic patellar fractures in 12 patients. All type I non-displaced 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 (1 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.
Therapeutic studies, level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence.
全膝关节置换术后髌骨骨折是一种罕见但具有挑战性的并发症。髌骨骨折可由创伤引起，也可能是无创伤性的。多种因素可导致假体周围髌骨骨折，包括患者相关因素、手术技术相关因素和植入物特定因素。了解导致无创伤性髌骨骨折的病因因素可减少并发症。我们报告了12例假体周围髌骨骨折的结果。所有I型无移位骨折（7例）均采用非手术治疗。其余5例选择手术治疗，包括切除关节成形术联合骨折切开复位内固定（3膝）、部分髌骨切除术（1膝）和全髌骨切除术（1膝）。在最近一次随访时，1膝结果为优，8膝为良，其余3膝为中。有2例再次手术；1例因伸肌机制破坏，1例因再骨折。1例患者发生浅表伤口感染。我们回顾了有关假体周围髌骨骨折的病因、手术策略和结果的现有文献。
治疗性研究，IV级（病例系列）。有关证据水平的完整描述，请参见作者指南。
