Functional Outcomes of Patella Fractures Treated With Anterior Plate Osteosynthesis at One Year

OBJECTIVES:To evaluate the functional outcomes of patients with displaced patellar fractures treated with anterior plate constructs. DESIGN:Prospective cohort and retrospective clinical and radiographic assessment. SETTING:Level I Trauma Center.Patients/ParticipantsBetween 2014 and 2018, eighteen patients who underwent operative intervention for an isolated, displaced patella fracture (AO/OTA 34 C1-3) with a minimum of 1-year follow-up agreed to participate in the study. Mean follow-up was 19.5 ± 6.0 months. INTERVENTION:Patients were treated with 2.4 or 2.7-mm plates as well as supplemental screws or cerclage wires. MAIN OUTCOME MEASUREMENTS:Patients were evaluated with the SF-36 and the Knee Injury and Osteoarthritis Outcome Scores (KOOS) and asked about symptomatic hardware. Range of motion was assessed by goniometer. RESULTS:The cohort had no wound complications, infections, nonunion, loss of reduction or implant failure. Active knee flexion was 131 ± 7°. Five patients (28 %) endorsed implant irritation. Only one patient (5.5 %) underwent implant removal, which consisted of transverse screw removal only. Twelve of the fourteen patients (86%), who were previously employed, returned to work at 10 ± 7 weeks. All KOOS subscale scores and the SF-36 scores for physical functioning, limitations due to physical health, limitations due to mental health, and social functioning were significantly lower than reference population norms (p < 0.05). CONCLUSIONS:Anterior plating provides reliable fixation for displaced patellar fractures and results in a low incidence of implant irritation. However, patients who had anterior fixation for displaced patella fractures continue to exhibit functional deficits at one year post-operatively. LEVEL OF EVIDENCE:Therapeutic Level IV