Patellar Fracture Repair
What you should know
A patellar fracture repair is surgery to repair a fractured and displaced patella.
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- You may get an infection in your kneecap or the tissue around it. In some cases, the infection may spread to your knee joint and cause pain and swelling. The hardware in your knee may break or come loose. You may have stiffness in your knee after your kneecap has healed. Scar tissue may form on and under your skin where you had surgery. As scar tissue forms, it may stick together, causing adhesions. These adhesions may limit movement and cause a longer recovery time.
- You may have less motion and strength in your knee after a patellectomy. Your thigh muscle may be weak, and you may have trouble climbing stairs. You may have posttraumatic arthritis after a partial patellectomy. This is a form of joint swelling caused by the injury and surgery. You may have a nonunion of your kneecap. A nonunion is when the bones do not heal properly after a fracture. Nonunion may be caused by too much movement or an infection after surgery. You may need the same surgery again or a different type of surgery to repair your kneecap. Even after surgery, you may still have pain and other signs and symptoms.
- You may get a blood clot in your leg. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening. If you do not have surgery, the pain and problems you have may worsen. Your knee may get weak, or you may have problems walking.
Before your surgery:
- Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
- Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
- You may need to wear a splint or brace on your leg until surgery. This helps decrease movement and helps prevent further injury to your kneecap.
- If you have cuts and injuries to the skin on your knee, surgery may be delayed until the injuries heal.
- You may need an x-ray, CT scan, or MRI before surgery. These tests take pictures of your knee so caregivers can see the fracture. Caregivers can also check for damage to the tissues, blood vessels, and muscles in and around your knee. Caregivers use these tests to help plan your surgery. Ask your caregiver for more information about these and other tests you may need. Write down the correct date, time, and location of each test.
The night before your surgery:
- Ask caregivers about directions for eating and drinking.
The day of your surgery:
- Write down the correct date, time, and location of your surgery.
- You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
- Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
- An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.
What will happen:
- You will be taken to the surgery room where you will lie on your back on a table or bed. You may be given spinal or epidural anesthesia so you will not feel pain below your waist during surgery. With spinal or epidural anesthesia, you will be awake during your surgery. You may get general anesthesia during surgery to keep you asleep and free from pain. Caregivers will work with you to decide which anesthesia is best for you. Caregivers will clean your skin with a special soap to help prevent infection. Sheets will be put over your knee to keep the surgery area clean.
- With an arthroscopic reduction and fixation, small incisions are made in the skin over your kneecap. An arthroscope (thin tube with a camera on the end) and other small tools are put through the cuts. With an open reduction and fixation, caregivers make a larger cut in the skin to open it for repair. With a partial or total patellectomy, caregivers make a cut and remove part, or all, of your kneecap. The fractured pieces of your kneecap are put back in their correct places. Your caregivers may use hardware, such as wires, screws, or other materials, to hold the pieces together. At the end of surgery, the cuts are closed with stitches and covered with bandages. Bandages help keep the area clean and dry to help prevent infection.
After your surgery:
- You are taken to a room where you can rest. You will have a splint, brace, or cast on your knee. This will protect the kneecap and stop it from moving while it heals. Caregivers will check on you often. A caregiver may remove the bandage soon after your surgery to check the area. Do not get out of bed until your caregiver says it is okay. When caregivers see that you are ready, you may be allowed to go home. If you are staying in the hospital, you will be taken to your room.
- Follow your caregiver's instructions about knee movement after surgery. This is very important because it may help prevent displacing your kneecap or other problems after surgery.
This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.
Contact a caregiver if
- You cannot make it to surgery on time.
- You have questions or concerns about your surgery.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.