Patellar fracture during knee replacement surgery

Thank you for asking about my husband. His mobility is slowly progressing. He's locked straight while weight bearing and while resting has done 2 weeks at a 30 degree bend. He's now almost done with 2 more weeks at 60, but not there yet. Then Monday he can progress to 2 weeks at 90 degrees. It's like watching paint dry for him. 8 weeks of not being able to rehab is frustrating. I'm sure you understand. He almost needed MUA 2 years ago with his first replacement, but eventually got there. Fun fact -my husband installs flooring for a living and it's beyond me how he ever got back on his knees after round one, let alone with this revision plus a patellar tendon tear.

You should give yourself a pat on the back! You've been through a rough go at it. I hope this is not a stupid question, I'm trying to understand - did your rare happenings mean you were unable to receive an actual TKR? Can they replace the knee cap with a full prosthetic?

Thanks for asking, and not a stupid question. My surgeon did continue with the implant, but needed to remove the non viable bone pieces, reattach the avulsed patellar tendon to the remaining kneecap, then run the sutures through holes in the patella to the quadriceps tendon and back. He then basically cinched it all together and closed it. The patella he was able to save was still attached to the quadriceps tendon but was in a few pieces as well. He said it was like when a big rock hits your windshield and shatters. He said it shocked him when it happened. I don't know how many pieces it broke into but it was at least 6. Obviously I didn't get the whole replacement since the part that is usually placed under the patella couldn't be attached. Your husband is making amazing progress! I wish mine was as good. No patella replacement for me. No further surgical procedures are recommended. I'm seeking a second opinion.

I'm really sorry to hear about this. I know the fact that it's rare is of no comfort. I'm just wondering if they can replace the entire patella using the same substance for the meniscus (hardened polyethylene). or perhaps metal.

Again, I'm terribly sorry. I do agree a CT scan will be more useful than an X-ray or MRI, as it will provide a 3D picture of the entire knee.

Stay strong. Joe

What an ordeal. I feel there is hope out there for you and agree with a second, even third opinion if need be.

Here's a link to inquire with Mayo Clinic, should you be interested:

- http://mayocl.in/1mtmR63

Do you live near any large teaching hospitals?

I live in the country in Western Washington state. I'm pretty sure the closest teaching hospital is in Seattle. I was able to get an appointment next week with an Orthopedist locally who has great credentials and specializes in difficult cases such as mine.

Okay, that sounds like a great place to start. Good luck with your appointment this week. I'm glad you got in so quick. That's awesome!

I'm a little invested now, would you mind letting me know how all goes?

If you're interested I can give you a little more details about my pre operative condition.

Hi. You are more than welcome to share your pre-operative condition. It's possible it may help another member who went through or is going through a similar situation.

How did your appointment with the specialty orthopedist go?

I have scarring in both quadriceps which causes contractures in both knees and limits my ROM to 90 degrees in my TKA knee (pre-op) and 40 or so in my non-operative knee. I'm at 40 degrees or so in the affected knee as well. So I have limited mobility and stability in both knees and they buckle sometimes. The Dr I saw yesterday took x-rays and said that the implant was okay but thought the patella was possibly too high. He also thought that the quadriceps tendon and the patella tendon repair might be allowing the patella to move unnaturally and be the cause of my chronic pain. He also ordered an MRI which is more than my original surgeon did. I'm not sure what can be done to fix it if that is the issue but at least I will know the cause and not just the symptom.