55-284
Actualización en osteonecrosis y fractura de rótula tras prótesis total de rodilla
Update on osteonecrosis and patella fracture de after total knee replacement.
RODRÍGUEZ COLLELL JR1 , MIFSUT MIEDES D1, 2 1. DEPARTAMENTO DE SALUD CLÍNICO-MALVARROSA DE VALÈNCIA 2. DEPARTAMENTO DE CIRUGÍA UNIVERSITAT DE VALÈNCIA
Recepción:
13/04/2021
Aceptación:
13/04/2021
Publicación:
13/04/2021
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Resumen (ES)
Periprosthetic patella fractures are much more common in knee prostheses in which the patella has been replaced. The
aetiology of periprosthetic patella fractures has a traumatic origin in 12% of cases and atraumatic secondary to avascular
necrosis in the remaining 88%. Peri-implant fractures, in which the patella has been replaced and the implant is stable with
an integral extensor mechanism, resolve with conservative treatment. In cases of stable implant, with a displaced fracture
of the upper or lower pole of the patella, the implant is left in situ and the extensor apparatus is repaired according to
standard techniques. If there is disruption of the extensor apparatus with an unstable implant, the patellar button should be
removed and continuity of the extensor apparatus repaired with a patellectomy. In these cases, internal fixation with wire
cerclages is discouraged. In cases where the extensor mechanism is intact and the implant is unstable, the removal of the
patellar button is sufficient. The risk of infection after surgery for a periprosthetic patella fracture is high.
aetiology of periprosthetic patella fractures has a traumatic origin in 12% of cases and atraumatic secondary to avascular
necrosis in the remaining 88%. Peri-implant fractures, in which the patella has been replaced and the implant is stable with
an integral extensor mechanism, resolve with conservative treatment. In cases of stable implant, with a displaced fracture
of the upper or lower pole of the patella, the implant is left in situ and the extensor apparatus is repaired according to
standard techniques. If there is disruption of the extensor apparatus with an unstable implant, the patellar button should be
removed and continuity of the extensor apparatus repaired with a patellectomy. In these cases, internal fixation with wire
cerclages is discouraged. In cases where the extensor mechanism is intact and the implant is unstable, the removal of the
patellar button is sufficient. The risk of infection after surgery for a periprosthetic patella fracture is high.
Palabras clave (ES):
arthroplasty
complications
osteonecrosis
patella
fracture
total
knee
prosthesis
knee
Resumen (EN)
Periprosthetic patella fractures are much more common in knee prostheses in which the patella has been replaced. The
aetiology of periprosthetic patella fractures has a traumatic origin in 12% of cases and atraumatic secondary to avascular
necrosis in the remaining 88%. Peri-implant fractures, in which the patella has been replaced and the implant is stable with
an integral extensor mechanism, resolve with conservative treatment. In cases of stable implant, with a displaced fracture
of the upper or lower pole of the patella, the implant is left in situ and the extensor apparatus is repaired according to
standard techniques. If there is disruption of the extensor apparatus with an unstable implant, the patellar button should be
removed and continuity of the extensor apparatus repaired with a patellectomy. In these cases, internal fixation with wire
cerclages is discouraged. In cases where the extensor mechanism is intact and the implant is unstable, the removal of the
patellar button is sufficient. The risk of infection after surgery for a periprosthetic patella fracture is high.
aetiology of periprosthetic patella fractures has a traumatic origin in 12% of cases and atraumatic secondary to avascular
necrosis in the remaining 88%. Peri-implant fractures, in which the patella has been replaced and the implant is stable with
an integral extensor mechanism, resolve with conservative treatment. In cases of stable implant, with a displaced fracture
of the upper or lower pole of the patella, the implant is left in situ and the extensor apparatus is repaired according to
standard techniques. If there is disruption of the extensor apparatus with an unstable implant, the patellar button should be
removed and continuity of the extensor apparatus repaired with a patellectomy. In these cases, internal fixation with wire
cerclages is discouraged. In cases where the extensor mechanism is intact and the implant is unstable, the removal of the
patellar button is sufficient. The risk of infection after surgery for a periprosthetic patella fracture is high.
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