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Patellar fracture during knee replacement surgery

Posted by krikett @krikett, Feb 5, 2023

I'm 8 ish months post total knee replacement. I suffered an inter operative comminuted patella fracture with half of my kneecap removed. I had 5 months of home health visits for PT and OT. I have been in chronic pain since day 1. I did, and still do, my best effort at strength, ROM and balance. What now? I'm only 40 flex on a good day.

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krikett | @krikett | Feb 23, 2023

I re-read the after visit summary and the x-ray showed a bone fragment was found near my patella (maybe a bit off the fracture) I'm not sure. Maybe that's why he wanted the MRI?

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Mentor
Rachel, Volunteer Mentor | @rwinney | Feb 28, 2023
In reply to @krikett "I have scarring in both quadriceps which causes contractures in both knees and limits my ROM..." + (show)
@krikett

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.

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Knowing the cause and not just the symptom is peace of mind. You must be thankful to be receiving clarity. Maybe your MRI with continue to prove more, like you wonder. Continued forward progress with this new doctor... good luck!!

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patellaprob | @patellaprob | Aug 12, 2023

I’m looking for some input … I will be one year post op later this month. During the procedure, my patella was fractured during resurfacing. I was in an immobilizer for almost 8 weeks. After that I had a forced manipulation and debridement to clean up the cement used to put my kneecap back together. Unfortunately, it appears the it isn’t staying together. The surgeon says a revision isn’t possible due to insufficient bone stock. As my pain has been increasing, I find myself not knowing what to do from here ….

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Moderator
Justin McClanahan, Moderator | @JustinMcClanahan | Aug 14, 2023

Hello @patellaprob. I moved your discussion and combined it with an existing discussion on the same topic:

- Patellar fracture during knee replacement surgery
https://connect.mayoclinic.org/discussion/patellar-fracture-during-knee-replacement-surgery
I moved your post here so you could read through others' experiences with this similar issue and so you could meet @krikett, who had an experience quite similar to your own.

@patellaprob, because you are not eligible for a revision due to your insufficient bone stock, what has been suggested to you for a path forward to address your patella and pain? What sort of range-of-motion were you able to achieve with being in an immobilizer for 8 weeks post-op? That must have been a tough recovery without any PT.

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1 reply
patellaprob | @patellaprob | Aug 15, 2023
In reply to @JustinMcClanahan "Hello @patellaprob. I moved your discussion and combined it with an existing discussion on the same..." + (show)
@JustinMcClanahan

Hello @patellaprob. I moved your discussion and combined it with an existing discussion on the same topic:

- Patellar fracture during knee replacement surgery
https://connect.mayoclinic.org/discussion/patellar-fracture-during-knee-replacement-surgery
I moved your post here so you could read through others' experiences with this similar issue and so you could meet @krikett, who had an experience quite similar to your own.

@patellaprob, because you are not eligible for a revision due to your insufficient bone stock, what has been suggested to you for a path forward to address your patella and pain? What sort of range-of-motion were you able to achieve with being in an immobilizer for 8 weeks post-op? That must have been a tough recovery without any PT.

Jump to this post

The problem is that nothing is suggested…it’s almost like my condition has been waved off. No future appointments.. My surgeon indicated that he would write me permanent restrictions to give to my employers. Absolutely not what I wanted to hear as I have two full time jobs both of which are necessary for me to continue working to support myself. As for the pain, it continues to worsen every day. Each morning I am awoken by a pain that surges from my knee with even the slightest leg movement. I choose to not take pain meds. I don’t like how they make me feel. I am only 57 years old. I can’t imagine living the rest of my life likes this.

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