A broken kneecap occurs when the small round bone (the patella) at the front of the knee joint fractures. This is a common injury, as about 1% of all bones broken are kneecaps 1. Such factures most often result from a direct blow to the knee, such as a in a motor vehicle accident or fall. This can result in either a simple or complex kneecap fracture, sometimes alongside injuries to knee tendons and ligaments. In the most severe cases, kneecap fractures may require surgery. In all cases, recovery from a kneecap fracture requires care and planning.
Initially following a fracture, for many patients, using ice, elevating the leg, and taking non-prescription analgesic medications suffice to relieve the pain. If severe pain persists, a patient may be administered a prescription-strength medication such as an opioid for a few days 2.
For the most extreme kneecap fractures, surgical treatment may be required; the type of surgical intervention depends on the type of fracture. Surgical repairs may remove small fragments of bone, fix any damage incurred to the patellar ligament and other structures of the knee, and place pins, screws, or wires to hold large chunks of the patella together 1.
Recovery following a kneecap fracture must be deliberately and carefully carried out. A patient’s physical and occupational therapy teams will recommend exercises and weight-bearing restrictions specifically catered to each stage of recovery, and a brace may be prescribed 1. A patient might need to avoid climbing stairs, kneeling, squatting, or engaging in any other activity that could strain the knee. In most cases however, most patients are still able to walk even while the knee is immobilized and healing.
However, weeks to months of immobilization with a splint cast may result in atrophy of the leg. Physical therapy can help minimize atrophy, as well as enhance a patient’s range of motion—while boosting muscle strength and decreasing stiffness.
After their provider gives them the green light, an individual can return to sports, likely after two to six months—beginning with walking or swimming, slowly building up the strength and stamina to begin sports that require jumping or making quick turns. Any pain-incurring activity should be discontinued, however 3. Depending on a patient’s age and health status, recovery from a kneecap fracture may take up to six months.
Even following successful treatment, some patients with patellar fractures experience long-term complications 2. First, post-traumatic arthritis may develop, which occurs when the cartilage in the knee joint has been damaged. Up to half of individuals having recovered from a fractured kneecap report arthritis after eight years 4. Second, some patients may suffer from permanent weakness of the quadriceps; this loss of strength is not usually disabling, however. Finally, many patients may experience long-term pain in the front of the knee. As a result of these complications, some people choose to continue wearing a knee brace for full support 4. Severe post-traumatic osteoarthritis or strong persistent knee pain may warrant a thorough reassessment and further surgery. This may include a knee replacement 1.
Following best practices and adhering to the guidelines set forth by a recovery team will ensure that patients recover swiftly and efficiently from kneecap fracture.
References
1. Kneecap Fractures (Patella Fractures) | Johns Hopkins Medicine. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/kneecap-fractures. (Accessed: 9th December 2022)
2. Patellar Fractures (Broken Kneecap) – OrthoInfo – AAOS. Available at: https://orthoinfo.aaos.org/en/diseases–conditions/patellar-kneecap-fractures/. (Accessed: 9th December 2022)
3. Broken kneecap – aftercare: MedlinePlus Medical Encyclopedia. Available at: https://medlineplus.gov/ency/patientinstructions/000582.htm. (Accessed: 9th December 2022)
4. Patella Fracture: Types, Symptoms, Treatment & Surgery. Available at: https://my.clevelandclinic.org/health/diseases/22081-patella-fracture. (Accessed: 9th December 2022)