Health Information

Patella Fracture

Definition

This injury happens when there is a break in the patella. The patella is a large, movable bone at the front of the knee.

The Kneecap
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Causes

Some common causes of this injury include:

  • Sharp blow to the knee
  • Excessive stress on the knee

Risk Factors

Factors that may increase your risk of developing a patella fracture include:

  • Increased age
  • Postmenopause
  • Decreased muscle mass
  • Osteoporosis—decreased bone mass
  • Participation in contact sports such as football and soccer
  • Obesity, which places strain on muscles, bones, tendons, and ligaments
  • Violence, such as car or car-pedestrian accidents

Tell your doctor if you have any of these risk factors.

Symptoms

If you have any of these symptoms do not assume it is due to a patella fracture. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

  • Sudden, excruciating pain in the kneecap
  • Swelling, bruising, and tenderness
  • Inability to extend the knee
  • Difficulty walking

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will look closely at the knee to see if there are signs of fracture. A straight leg test may be done.

Images may be taken of your bodily structures. This can be done with:

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Nonsurgical Approach

After the tests, your doctor will determine whether you need surgery. If the patella is not badly injured, your doctor will place the knee in a cast. This cast may need to be worn for six weeks. After that, you will wear a knee brace and do physical therapy. You may need to use a cane or a crutch.

Your doctor may recommend pain medication to reduce pain and swelling.

Surgery

If the patella is in pieces, then you will need surgery. There are two kinds of surgery that are commonly used to treat this injury:

  • Open reduction-internal fixation surgery—The doctor uses pins and screws to put the broken pieces back together.
  • Patellectomy—Rarely, the doctor removes part of the kneecap or the entire kneecap.

After surgery, you will need to do physical therapy. This can involve range-of-motion exercises and stretching. You will slowly build strength in the injured leg. In some cases, another surgery will be needed to remove the pins and screws.

Depending on the injury, recovery can take weeks to several months.

Prevention

To help reduce your chance of getting a patella fracture, take the following steps:

  • Do not put yourself at risk for trauma to the bone.
  • Do weight-bearing exercises to build strong bones.
  • Build strong muscles to prevent falls and to stay active and agile.
  • Wear proper padding and safety equipment when participating in sports or activities.

Revision Information

  • American Academy of Orthopaedic Surgeons

    http://orthoinfo.aaos.org

  • American Physical Therapy Association

    http://www.orthopt.org

  • Canadian Orthopaedic Association

    http://www.coa-aco.org

  • Canadian Orthopaedic Foundation

    http://www.canorth.org

  • Henry P, Panwitz B, et al. Rehabilitation of a post-surgical patella fracture. Physiotherapy. 2000;86:139-142.

  • Patellar (kneecap) fractures. American Academy of Orthopaedics website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00523. Updated March 2010. Accessed September 9, 2013.

  • Stress fractures. The American College of Foot & Ankle Orthopedics & Medicine website. Available at: http://www.acfaom.org/information-for-patients/common-conditions/stress-fractures. Accessed November 18, 2008.

  • Tay G, Warrier S, et al. Indirect patella fractures following ACL reconstruction. Acta Orthopaedica. 2006;77:494-500.