Table of ContentsView AllTable of ContentsSymptomsCausesTreatmentRehabFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Treatment
Rehab
Frequently Asked Questions
The kneecap is one of three bones that make up theknee joint. Thepatellais coated with cartilage on its undersurface and is important in providing strength when extending (straightening) the knee joint.
This article discusses the symptoms and causes of patella fractures. It also covers how they are treated and what to expect during recovery.
Verywell / Gary Ferster
Patella Fracture Symptoms
Patella fractures can cause severe pain and difficulty walking. Some of the more common symptoms of this injury include the following:
A patella fracture most often occurs from a fall directly onto the kneecap.When the fracture occurs due to this type of direct trauma, there is often damage to the overlying skin, and because of the limited amount of soft tissue, this can sometimes become anopen fracture.
Patella fractures can also occur when thequadriceps muscleis contracting but the knee joint is straightening (an “eccentric contraction”). When the muscle pulls forcefully in this manner, the patella can fracture.
Patella fractures should be seen in the emergency room. X-rays will determine the type of fracture and the amount of displacement (separation) of the fracture.One of the critical factors in determining treatment is a thorough examination.
This tests the function of the quadriceps muscle and its attachment to the shin bone (tibia). A disruption of the quadriceps tendon, patella, or patellar tendon can lead to the inability to perform a straight leg raise. If a straight leg raise can be done, then non-operative treatmentmaybe possible in the setting of a patella fracture.
The Straight Leg Raise Test
Nonsurgical Treatment
Patients with nondisplaced (not separated) or minimally displaced fractures who can perform a straight leg raise (as described above) can usually be treated without surgery. Treatment for these types of patellar fractures may include a long leg cast or a knee immobilizer to hold the leg in place while the bone heals.You may also have to limit your activity and avoid placing weight on your knee.
Patella Fracture Surgery
When surgery is necessary, an incision is made over the front of the knee joint. The fractured ends of the bone are realigned and held in place with some combination of pins, screws, and wires.In some cases, a portion of the patella can simply be removed, but this is usually done for smaller bone fragments. Damage to any other structures in the knee joint (such as the patellar ligament) may also require surgical repair.
Rehab After Surgery
In some cases, early motion of the knee may help to achieve the best results after surgery, but check with your healthcare provider for what is best and safest for your type of injury. They may recommend physical therapy and occupational therapy.
The most common complication of patella fracture surgery is stiffness of the knee. Another complication is that the metal implants can become painful over time—especially when kneeling.
It is not uncommon for a second procedure to be needed to remove the metal implants. This procedure is usually done at least a year after the initial surgery.
Other possible complications include:
One of the important aspects of surgery is to realign the bones and cartilage surface of the kneecap to minimize the development of arthritis of the knee joint. Because of damage to the knee joint cartilage when a fracture occurs, there is a higher chance of developing arthritis of the joint.
If kneecap arthritis becomes severe, some people may ultimately need aknee replacementor apartial knee replacementof the kneecap.
Frequently Asked QuestionsSince you’ll be wearing a brace, cast, or splint to keep your knee immobile, sleeping on your back is likely to be most comfortable position. You may also want to use pillows underneath the knee to keep it slightly elevated.Icing the kneea half-hour to an hour before bed, and taking any pain medications you’ve been prescribed, such asNSAIDs, can help you get to sleep.It can take three to six months, on average, to return to prior activity levels after treatment for a patellar fracture.Your recovery time will depend on your physical therapy goals, whether you had surgery or nonsurgical treatment, and the seriousness of your injury.After your patellar fracture repair, exercise options will vary depending on your stage of recovery. Whether you’ve had surgical or nonsurgical treatment—both of which involve a period of knee immobilization—you’ll initially be limited to non-weight-bearing exercise that does not stress your knee. As you heal, you’ll begin weight-bearing, knee-extension, and quadriceps-strengthening exercises in physical therapy, which is an essential part of the recovery process.The patella connects the quadriceps muscle of the thigh to the bones of the lower leg, and it is essential to walking. Since you will likely not be able to place any weight on a knee with a fractured patella, it will be difficult, if not impossible, to walk until it is repaired.
Since you’ll be wearing a brace, cast, or splint to keep your knee immobile, sleeping on your back is likely to be most comfortable position. You may also want to use pillows underneath the knee to keep it slightly elevated.Icing the kneea half-hour to an hour before bed, and taking any pain medications you’ve been prescribed, such asNSAIDs, can help you get to sleep.
It can take three to six months, on average, to return to prior activity levels after treatment for a patellar fracture.Your recovery time will depend on your physical therapy goals, whether you had surgery or nonsurgical treatment, and the seriousness of your injury.
After your patellar fracture repair, exercise options will vary depending on your stage of recovery. Whether you’ve had surgical or nonsurgical treatment—both of which involve a period of knee immobilization—you’ll initially be limited to non-weight-bearing exercise that does not stress your knee. As you heal, you’ll begin weight-bearing, knee-extension, and quadriceps-strengthening exercises in physical therapy, which is an essential part of the recovery process.
The patella connects the quadriceps muscle of the thigh to the bones of the lower leg, and it is essential to walking. Since you will likely not be able to place any weight on a knee with a fractured patella, it will be difficult, if not impossible, to walk until it is repaired.
3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Orthopaedic Surgeons. OrthoInfo.Patellar (kneecap) fractures.Johns Hopkins Medicine.Kneecap fractures (patella fractures).MedlinePlus.Broken kneecap - aftercare.Additional ReadingGwinner C, Märdian S, Schwabe P, Schaser KD, Krapohl BD, Jung TM.Current concepts review: Fractures of the patella.GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW; 2016;5:Doc01. doi:10.3205/iprs000080
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Orthopaedic Surgeons. OrthoInfo.Patellar (kneecap) fractures.Johns Hopkins Medicine.Kneecap fractures (patella fractures).MedlinePlus.Broken kneecap - aftercare.Additional ReadingGwinner C, Märdian S, Schwabe P, Schaser KD, Krapohl BD, Jung TM.Current concepts review: Fractures of the patella.GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW; 2016;5:Doc01. doi:10.3205/iprs000080
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Orthopaedic Surgeons. OrthoInfo.Patellar (kneecap) fractures.Johns Hopkins Medicine.Kneecap fractures (patella fractures).MedlinePlus.Broken kneecap - aftercare.
American Academy of Orthopaedic Surgeons. OrthoInfo.Patellar (kneecap) fractures.
Johns Hopkins Medicine.Kneecap fractures (patella fractures).
MedlinePlus.Broken kneecap - aftercare.
Gwinner C, Märdian S, Schwabe P, Schaser KD, Krapohl BD, Jung TM.Current concepts review: Fractures of the patella.GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW; 2016;5:Doc01. doi:10.3205/iprs000080
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
