Patellar fracture after total knee arthroplasty with retenti
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A total of 2954 TKAs with patella retention were examined retrospectively. Patellar fractures were found to be common. The non-patellar fracture control (randomly selected after age and sex matching) and patellar fracture patient groups were compared on perioperative demographic factors associated with patellar fracture.

The Hospital for Special Surgery knee score, union rates, and complications after treatment were analyzed to confirm the prognosis of reported patellar fractures. The results of treatment were compared by treatment process, and fracture types were categorized by form.

Results:
--For primary TKAs with patella retention, patellar fracture occurred in 32 of 2883 cases.

--When comparing the preoperative demographic factors between the patellar fracture and control groups, there was a significant difference in knee flexion of the affected limb.

--23 cases were treated nonoperatively, and 9 cases were treated operatively.

--Of the 32 patellar fractures, 28 had confirmed union, and the HSS score at the latest follow-up increased significantly from the preoperative score. The only complication noted after treatment was nonunion in three cases.

There were no significant differences in treatment results according to the treatment method and fracture type.

To summarize, patellar fracture after TKA with retained patella is uncommon, with clinicoradiological outcomes that are superior to patellar fracture after TKA with resurfaced patella. Treatment process and fracture form had no impact on the improved performance.

Source: https://www.arthroplastyjournal.org/article/S0883-5403(21)00336-3/fulltext
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