The Use of Dual Reconstruction Plates for Failed Fixation of Patellar Fracture after Total Knee Replacement: A Case Report.

Sa-Ngasoongsong P,Kawinwonggowit V,Wongsak S,Suphachatwong C,Chulsomlee K

doi:10.5704/moj.1611.012

Abstract

Patellar fracture after total knee replacement (TKR) is one of the challenging problems in periprosthetic fracture. Open reduction with internal fixation (ORIF), as tension band wiring (TBW), usually required in cases with extensor mechanism disruption. However, many studies reported a high failure rate after using this technique. In this report, we presented an interesting case of periprosthetic patellar fracture after TKR with TBW failure that was successfully treated with double non-locking reconstruction plates fixation and TBW augmentation.

Highlights

Periprosthetic patellar fracture (PPF) is the second most common fracture following total knee replacement (TKR) with the prevalence of 0.7-1.2%
Surgical options were open reduction and internal fixation (ORIF), patelloplasty, partial patellectomy with reattach the tendon to the remaining bone and total patellectomy according to fracture type and stability of the implant 2
The outcome after these methods was still unconvincing as 50% complication rate and 42% re-operation rate 2, and ; ORIF with tension band wiring (TBW) was not recommended as the first choice of treatment due to a high rate of fixation failure, and risk of nonunion 1

Summary

INTRODUCTION

Periprosthetic patellar fracture (PPF) is the second most common fracture following total knee replacement (TKR) with the prevalence of 0.7-1.2%. The outcome after these methods was still unconvincing as 50% complication rate and 42% re-operation rate 2, and ; ORIF with tension band wiring (TBW) was not recommended as the first choice of treatment due to a high rate of fixation failure, and risk of nonunion 1. The aim of this case report was to demonstrate a case of PPF after TKR and complicated with TBW failure that was successfully treated with ORIF using double reconstruction plates fixation and TBW augmentation

CASE REPORT

DISCUSSION