JBJS | Patella Infera After Nonoperative Treatment of a Patellar Fracture : A Case Report

The Journal of Bone & Joint Surgery, Volume 84, Issue 6

Case Reports | June 01, 2002

Patella Infera After Nonoperative Treatment of a Patellar Fracture : A Case Report

Saam Morshed, MD; Michael D. Ries, MD

The Journal of Bone & Joint Surgery. 2002; 84:1018-1021

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Patella infera is a pathologic shortening of the patellar tendon, secondary to disease, trauma, or surgery, that can lead to knee pain and patellofemoral arthrosis. Caton et al. ¹ coined the term patella infera in 1982 and found that the condition was frequently associated with chronic knee pain. In 1986, Wojtys et al. ² presented radiographic and clinical findings for a group of patients in whom the condition developed following trauma or surgery about the knee joint. Patella infera has most commonly been reported as a complication of reconstruction of the anterior cruciate ligament ^3-5 . Windsor et al. ⁶ , in a study of patients managed with total knee arthroplasty after a failed proximal tibial osteotomy, found that 80% of forty-one knees had patella infera after the osteotomy and before the arthroplasty. Osteotomy of the tibial tubercle and repairs of patellar tendon ruptures also have been associated with the condition ⁷ . Traumatic causes of patella infera such as rupture of the quadriceps tendon, fracture of the femoral shaft, and intra-articular fracture of the knee have also been described ^2,8 . Patella infera was reported in association with surgically treated patellar fractures in six of fifty patients in one series ⁸ .

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patellar fracture ; patella infera ; patella ; knee joint

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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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Martin Altchek

Posted on June 18, 2002

Patella fracture treatment

Horton Medical Center, Middletown, New York

Since 1954 in a general Orthopedic practice I have treated all fractured patellas with an intact quadriceps with immediate active exercise. This excludes a very few patients upon whom I have operated. I can not recall any that have pulled apart or had other complications or failed to heal. I believe the early motion smoothes the articular surface to some extant, and that in this case, immobilization contributed to the poor result.

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