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Patellar Fractures After Total Knee Replacement

¹ Department of Radiology, The University of Iowa Hospital and Clinics, 200 Hawkins Dr., Iowa City, IA 52242.

View larger version (140K): [in a new window]   Fig. 1A —59-year-old woman with transverse fracture of right patella 12 months after total knee replacement. Lateral radiograph of right knee shows linear nondisplaced fracture at mid patella.

View larger version (147K): [in a new window]   Fig. 1B —59-year-old woman with transverse fracture of right patella 12 months after total knee replacement. Follow-up lateral radiograph obtained 12 months after A shows increased displacement of fracture fragments. Pain in right knee had increased substantially since radiography examination 12 months earlier (A).

View larger version (117K): [in a new window]   Fig. 2 —53-year-old woman with avulsion fracture of left patella. Lateral radiograph shows avulsion fracture (arrow) at superior pole of patella.

View larger version (132K): [in a new window]   Fig. 3A —82-year-old woman with comminuted fracture of right patella 2 months after total knee replacement. Lateral radiograph shows displaced fracture with several fragments proximally. This injury was associated with disruption of quadriceps tendon, which was confirmed surgically.

View larger version (90K): [in a new window]   Fig. 3B —82-year-old woman with comminuted fracture of right patella 2 months after total knee replacement. Merchant view shows vertical component of fracture.

View larger version (134K): [in a new window]   Fig. 4A —78-year-old man with fracture and presumed osteonecrosis of right patella. Lateral radiograph (A) and Merchant view (B) show fracture with fragmentation and bony sclerosis of patella.

View larger version (67K): [in a new window]   Fig. 4B —78-year-old man with fracture and presumed osteonecrosis of right patella. Lateral radiograph (A) and Merchant view (B) show fracture with fragmentation and bony sclerosis of patella.

View larger version (132K): [in a new window]   Fig. 5A —78-year-old man with refracture of patella. Lateral radiograph (A) and Merchant view (B) show initial fracture: vertical fracture with some fragmentation of patella.

View larger version (55K): [in a new window]   Fig. 5B —78-year-old man with refracture of patella. Lateral radiograph (A) and Merchant view (B) show initial fracture: vertical fracture with some fragmentation of patella.

View larger version (115K): [in a new window]   Fig. 5C —78-year-old man with refracture of patella. Follow-up lateral radiograph obtained 46 months after A and B shows new fracture: transverse fracture at midportion of patella.

View larger version (65K): [in a new window]   Fig. 6A —79-year-old woman with osteonecrosis after fracture. Merchant view shows patellar fracture.

View larger version (66K): [in a new window]   Fig. 6B —79-year-old woman with osteonecrosis after fracture. Follow-up Merchant view obtained 24 months after A shows marked fragmentation and sclerosis involving entire patella.

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