The surgical fixation of a patella fracture with hardware.
A patella fracture is a break in the kneecap, the small bone at the front of the knee that acts as a shield to the knee joint. Patella fractures are evaluated by your doctor to determine if they are nondisplaced, stable fractures or if they are displaced, unstable fractures. If the fracture is stable and the articular side of the patella (the bottom part of the kneecap that glides on the femur) stays in anatomic alignment, a conservative treatment plan can be utilized. This type of treatment includes the use of a brace or cast to immobilize the knee allowing the fracture to heal appropriately. This process takes approximately 6-8 weeks before rehabilitation therapy can begin. If a patella fracture is displaced, comminuted (in many pieces) or an open fracture, it is important to surgically realign the smooth articular surface. Patella fracture open reduction and internal fixation (ORIF) surgery is performed in a hospital setting. The type of fracture will dictate the type of surgery performed. If the fracture is a simple two-piece fracture, your surgeon may use a few long screws and wire or thick suture in a cerclage fashion. If the fracture is comminuted, a more intricate surgical approach may be necessary. Patella ORIFs require a post-operative period of strict immobilization and weight bearing restrictions. Once the fracture has healed, your doctor will begin to gradually allow the knee to bend. Because the knee was immobilized for an extended period of time, it is not uncommon for patients to experience weakness and stiffness during this stage. A physical therapy program will be prescribed to help decrease stiffness, improve motion and strengthen the muscles that surround the knee. The rehabilitation process can take 3-6 months to return to normal activities, however it could take longer for more severe fractures.
Every patient receives an in-depth consultation to devise a treatment plan that is right for their problem. Our specialists prefer non-operative and non-invasive treatments whenever possible, including physical therapy, medications, and/or injections. When we require surgery, we will then use minimally invasive surgical techniques to fix your problem, whether it is fixing a broken bone or repairing a tendon. Our goal is always to get you back to living your life normally as soon as possible.
With proper treatment, Dr. DeNoble can treat and fix even complete tears. He is an expert in the current minimally invasive standard of arthroscopic repair, avoiding the need for large incisions, and ensuring you can get back to your life in tip-top form.