Die periprothetische Patellafraktur

Zusammenfassung

Die periprothetische Patellafraktur zählt zu den seltenen Komplikationen nach endoprothetischem Ersatz des Kniegelenks. Ohne Patellaersatz wird diese Fraktur kaum beobachtet. Den meisten Frakturen geht kein eigentliches Trauma voraus. Patellanekrosen, Malalignment und Malrotation sind hier als wichtige Ursachen zu nennen. Die periprothetische Patellafraktur sollte konservativ behandelt werden. Die Behandlungsergebnisse sind in den meisten Fällen gut bis sehr gut. Die operative Behandlung ist nur bei erheblicher Dislokation der Fragmente und insuffizientem Streckapparat indiziert. Diese Behandlung ist außerordentlich komplikationsträchtig, die Ergebnisse sind schlecht.

Abstract

Periprosthetic patellafractures are rare complications after total knee replacements. They are even rarer without patellaresurfacing. Most fractures are observed without a real trauma, avascular necrosis, malalignment and malrotation are important factors. The periprosthetic patellafracture should be treated conservatively whenever possible. The published results are good to excellent in most cases. The operative treatment is only indicated in cases with severe dislocation and inefficiency of the extensor mechanism. These procedures have a very high complication rate, the results are poor.

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