Thorat Babaji, Singh Avtar, Vohra Rajeev, Bansal Sudhanshu
Department of Orthopaedic Surgery, Amandeep Hospital, Amritsar, Punjab, India.
J Orthop Case Rep. 2020 Sep;10(6):36-40. doi: 10.13107/jocr.2020.v10.i06.1866.
Periprosthetic patellar fracture after total knee arthroplasty (TKA) is an uncommon yet devastating complication, and management of these fractures is challenging with unreliable results. An isolated bilateral patellar fracture is often associated with systemic diseases, steroid usage, and repeated microtrauma. Isolated simultaneous bilateral periprosthetic patellar fracture after TKA is seldom reported in the literature.
This report consists of two cases of simultaneous isolated closed bilateral eriprosthetic patellar fracture after TKA, treated with open reduction and internal fixation of patella using tension band wiring. Union was achieved in both cases with satisfactory knee range of motion without significant extension lag.
Regardless of the fact that surgical outcome of periprosthetic fracture of the patella has unpredictable and poor results in past, it can be considered for acute traumatic periprosthetic patella fractures with less comminution and good bone stock to avoid revision arthroplasty and poor outcome.
全膝关节置换术（TKA）后假体周围髌骨骨折是一种罕见但具有破坏性的并发症，处理这些骨折具有挑战性且结果不可靠。孤立性双侧髌骨骨折常与全身性疾病、使用类固醇以及反复微小创伤有关。TKA后孤立性同时双侧假体周围髌骨骨折在文献中鲜有报道。
本报告包含两例TKA后同时发生的孤立性闭合性双侧假体周围髌骨骨折病例，采用张力带钢丝固定进行髌骨切开复位内固定治疗。两例均实现愈合，膝关节活动范围满意，无明显伸直滞后。
尽管过去髌骨假体周围骨折的手术结果不可预测且较差，但对于粉碎程度较轻且骨量良好的急性创伤性假体周围髌骨骨折，可考虑手术以避免翻修关节置换术及不良后果。
