A delayed transverse avulsion fracture of the superior pole of the patella after anterior cruciate ligament reconstruction.

Patella fractures following anterior cruciate ligament (ACL) reconstruction using central one third patella-tendon autograft is a recognized although rarely reported complication of this procedure. Twelve reports of patella fractures after ACL reconstruction exist in the literature, although only half of these fractures occurred postoperatively. Two of the nonacute fractures occurred approximately 6 months postoperatively, one of them being an avulsion of the inferior pole of the patella and the other being a displaced transverse avulsion fracture of the patella. We report on a nondisplaced transverse avulsion fracture of the superior pole of the patella that occurred 1 year after ACL reconstruction despite bone grafting the defect in the patella at the time of surgery. We are unaware of any report of this kind in the literature.