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What is a patella fracture?

The patella, known as the kneecap, protects the knee joint and helps link your thigh muscles to your lower leg. A patella (kneecap) fracture is a break in the bone that forms the kneecap. Because your kneecap (patella) acts like a shield for your knee joint, it is susceptible to fractures. This injury is usually caused by a direct blow to the knee or by a fall onto the knee. Kneecap fractures are serious injuries and often require surgery to heal. Over the long term, they may cause arthritis in the knee.


Do patella fractures vary from person to person?

Patellar (knee) fractures vary. The kneecap can crack just slightly, or can be broken into many pieces. A break in the kneecap can happen at the top, center, or lower part of the bone. Sometimes, fractures occur in more than one area of the kneecap. The type of fracture you sustain dictates the type of treatment you need.

Types of Patella Knee Fractures

The type of procedure performed often depends on the type of fracture you have. Before the surgery, your doctor will discuss your procedure with you, as well as any potential complications.

Transverse fracture
These two-part fractures are most often fixed in place using pins and wires and a "figure-of-eight" configuration tension band. The figure-of-eight band presses the two pieces together. This procedure is best for treating fractures that are located near the center of the patella. Another approach to a transverse fracture is to secure the bones using small screws, wires, and pins. In many cases, these wires and pins will need to be removed about a year or two after the surgery.

Comminuted fracture
In some cases, either the top or the bottom of the patella can be broken into several small pieces. This type of fracture happens when the kneecap is pulled apart from the injury, then crushed from falling on it. Because the bone fragments are too small to be fixed back into place, they will be removed. The surgeon will attach the loose tendon to the remaining patellar bone.

If the knee cap is broken in many pieces at its center (and they are separated), your surgeon may use a combination of wires and screws to fix it. Removing small portions of the kneecap may also have good results. Complete removal of the kneecap is a last resort in treating a comminuted fracture.


What are the symptoms of a patella fracture?

Symptoms of a patella fracture include pain and swelling in the knee, difficulty moving the knee, and a deformity or misalignment of the knee cap. 


What is the treatment for a broken knee cap?

Treatment for a patella fracture typically involves immobilizing the knee in a cast or brace and physical therapy to regain strength and range of motion. In more severe cases, surgery may be necessary to repair the fracture.


What types of surgery are used to help repair a patella fracture?

There are several types of surgery that may be used to repair a patella fracture, depending on the severity of the injury. Some common types of surgery include:

  • Closed reduction and percutaneous pinning: This procedure is used for simple fractures that can be realigned without making an incision in the skin. The surgeon uses special pins or wires designed for this purpose to hold the pieces of the bone in place while they heal.
  • Open reduction and internal fixation: This procedure is used for more complex fractures that cannot be realigned with closed reduction. The surgeon will make an incision in the skin to access the bone and then use special screws, plates, or rods to hold the pieces of the bone in place.
  • Arthroscopy: This is a minimally invasive procedure in which the surgeon uses small incisions and a camera to repair the fracture.
  • Replacement of the knee joint: (total knee arthroplasty) A knee replacement is performed in some cases where fractures are severe and healing is not possible by other methods. 


The specific treatment option will depend on the location, size, and nature of the fracture, as well as the patient's overall health, age and activity level.


OrthoConnecticut’s team of board certified, fellowship trained knee specialists have a great deal of experience treating and repairing patella fractures. With state-of-the art treatment and the convenience of both surgery and follow-up care locally, the practice is the go-to destination for patella fracture diagnosis and treatment.

Related Resources:

Knee Fracture

Knee Stress Fracture Symptoms You Shouldn't Ignore

The animation content provided is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any specific questions you may have regarding a medical condition or procedure.