Adam B. Cohen, M.D. Alexandra Voigt, NP OrthoManhattan Our Staff
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Adam B. Cohen, MD

 Patella Fracture

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Home > Knee Conditions > Patella Fracture

Dr. Adam Cohen, an orthopedic surgeon in NYC, is an expert in the treatment of fractures of the patella and has over 20 years of experience treating fractures around the knee. He has been recognized as one of the best orthopedic surgeons and sports…

Patella (kneecap) Fracture

Overview

The patella or kneecap is the bone in the front of your knee. It is vulnerable to breaking with direct impact to the knee. For example, landing directly onto the knee or when the knee strikes the dashboard in a car collision.

It can break in several ways. Most commonly it breaks into two large pieces. The top piece is connected to the quadriceps tendon and the lower piece is connected to the patellar tendon.

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Evaluation

Pain and swelling in the front of the knee after a direct impact to the knee requires x-rays. X-rays will determine if there is a fracture of the a knee cap.

When the patella is broken there will typically be a large collection of blood inside the knee joint which your examiner may drain from your knee. This procedure is called an aspiration of hematoma. This will sometimes help relieve pain and allow for a better examination.

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When there is separation between the two pieces (called a displaced fracture) there is no ability to actively straighten out the leg from a bent position. Sometimes the kneecap can break and there is no separation of fragments (this is called a nondisplaced fracture). In this situation there is often an ability to straighten the leg despite the broken patella.

Treatment

The treatment for non-displaced fractures is casting or bracing for a period of 4-6 weeks. During this time it is important to obtain followup radiographs to make sure that a non-displaced fracture does not turn into a displaced fracture.

The recommended treatment for displaced fractures is surgery. The surgery is called open reduction and internal fixation (ORIF). ORIF of the patella is done through an open incision in the front of the knee. Either screws or metal wires are used to hold the fracture bony fragments in proper position until new bone heals.

Sometimes the screws, and wires will need to be removed at a later date because they may cause irritation to the front of the knee.