✅ Knee MRI Mastery/Chap 5CD. Cartilage Repair and TKA

(Fig 5-D.24) Insufficiency Fracture of the Unresurfaced Patella After TKA

MSK MRI 2024. 7. 21. 22:59

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📌 Atraumatic Patellar Fractures After TKA

✅ Etiology

Patellar fractures without trauma are rare in unresurfaced patella following TKA. The primary reasons for these fractures include:

  1. Osteonecrosis (Devascularization): Disruption of blood supply leading to necrosis.
  2. Excessive Patellar Removal: Aggressive resection during surgery.
  3. Implant-related Factors: Poor alignment of the patellar component or technical errors during placement.

 

✅ Imaging Findings

  • Increased sclerosis and fragmentation of the patella suggest osteonecrosis.
  • Progressive changes can be observed in follow-up imaging, indicating the development of insufficiency fractures.

 

✅ Management

  • For asymptomatic fractures of the patella with a well-functioning extensor mechanism, conservative treatment is recommended.
  • Continuous monitoring with follow-up imaging is essential to ensure the condition does not progress or cause symptoms.

 

References

  • Glob Med Therap, 2018 doi: 10.15761/GMT.1000105
  • Journal of Orthopaedic Surgery 2009;17(2):251-4
  • Semin Musculoskelet Radiol 2017;21:147–164
  • Semin Musculoskelet Radiol 2019;23:e20–e35.

 

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#AtraumaticFracture, #PatellarFracture, #TotalKneeArthroplasty, #Osteonecrosis, #ConservativeTreatment, #Radiology, #Musculoskeletal, #Orthopaedics, #Imaging, #MedicalEducation