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. 2022 Jul;142(7):1557-1561.
doi: 10.1007/s00402-021-03871-7. Epub 2021 Apr 6.

Influence of patella height after patella fracture on clinical outcome: a 13-year period

Pesch Sebastian  1 , Zyskowski Michael  2 , Greve Frederik  2 , Müller Michael  2 , Wurm Marcus  2 , Crönlein Moritz  2 , Biberthaler Peter  2 , Kirchhoff Chlodwig  2
Affiliations

Influence of patella height after patella fracture on clinical outcome: a 13-year period

Pesch Sebastian et al. Arch Orthop Trauma Surg. 2022 Jul.

Abstract

Introduction: The incidence of patella fracture is statistically low (0.5-1.5%) compared to other fractures of the extremities [Patella fractures 76(10):987-997, 2005]. In the latter research, patella fractures if treated surgically present an overall inferior functional outcome. Little is known about the influence of the postoperative patella height on the clinical outcome. Therefore, the aim of our study was to analyse the influence of the patella height on the patients' functional outcome after surgery.

Methods: In this retrospective study the in-house trauma register of our level I University trauma center was screened for patients suffering patella fractures treated surgically. Patella height of the same patients was evaluated on lateral X-rays using the Insall-Salvati Ratio (ISR). The patients' X-rays were analyzed at two time points for the ISR, whereas group A presents ISR data right after surgery and group B data at the latest follow up (minimum 6 weeks). The change of mean ISR at both time points was tested for significance. The functional outcome was measured by the "Munich Knee Questionaire" (MKQ). These MKQ results of different patella heights and fracture types were compared.

Results: The screening of our in-house trauma register revealed 375 patients between the years 2003 and 2016. Out of these 54 patients (34f, 20 m) were enrolled. In detail the follow-up time for ISR between group A and B accounted for a mean of 503.8 ± 655.7 days. The MKQ was assessed at a mean of 1367.0 ± 1042.8 days after surgery. According to the AO-classification 10% AO.34 type B and 90% AO.34 type C fractures were found. Group A showed in 9.1% a patella baja and in 27.3% a patella alta compared to group B presenting 20.0% patella baja and 14.5% patella alta. There was no significant difference in functional outcome referring to the MKQ in patella alta (MKQ 69.0% ± 18.2) or baja (MKQ 67.1% ± 17.9) (p = 0.9). No significant functional difference between AO34.type B (MKQ 74.5% ± 11.0) and AO34.type C fractures (MKQ 64.0% ± 15.0) resulted (p = 0.1).

Conclusion: Our results demonstrate that different postoperative patella heights apparently do not influence the functional outcome in the short follow-up.

Keywords: Comminuted patella fracture; Locking plate fixation; Patella alta; Patella baja; Patella fracture; Patient-oriented outcome measurement.

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Conflict of interest statement

The authors declare that there are no financial or personal conflicts of interests that could have influenced this work.

Figures

Fig. 1
Fig. 1
Lateral view (X-ray) of the knee showing the assessment of the Insall–Salvati Ratio (ISR, A/B)
Fig. 2
Fig. 2
Functional outcome in the mean MKQ score assessed on the latest follow-up is shown for all patella heights: patella baja, alta and norma (p = 0.2)
See this image and copyright information in PMC

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