Knee fracture surgery is a surgical procedure performed to correct the cracked or broken bones in or around the knee. These bones include the kneecap (patella), the tibia (shin bone), or femur (thighbone) where they connect with the knee. The purpose of knee fracture surgery is to restore normal anatomical function, stability, and movement.
Most knee fractures are caused by a direct hit to the knee.
Other common causes of knee fractures include:
- car accidents
- falls
- sports activities
Some of the common symptoms of knee fractures include:
- Bruising
- Pain
- Swelling
- Tenderness
- Muscle spasms
- Crackling or popping sound on movement
- Unable to walk
- Unable to bend or straighten the knee
Diagnosis
To make an accurate diagnosis and recommend the best treatment, the physician will:
- Review signs and symptoms,
- Review the medical history
- Determine how the injury occurred
- Physical Examination to assess the range of motion, swelling, and
- Order diagnostic tests: X-ray, CT scan, MRI scan, and/or bone scan
Treatment
Conservative measures such as casting, or bracing can be used for knee fractures that are not displaced.
Severe fractures that are displaced will require surgery to repair the fracture.
Hardware (screws and plates) are used
Common surgeries for fractured knee include:
- Arthroscopy: This is a minimally invasive knee surgery carried out by a flexible fiber-optic tube that contains a small lens or camera and a lighting system to magnify and illuminate structures inside a joint. The camera attached to the arthroscope shows the picture of the joint on a television screen allowing the surgeon to examine and correct the damaged area
Arthroscopy has many uses such as: repair or remove a torn meniscus, remove loose cartilage or bone fragments, treat kneecap problems, trim damaged articular cartilage, remove inflamed synovial tissue, treat knee sepsis, or reconstruct torn ligaments
- Anterior Cruciate Ligament (ACL) Reconstruction: ACL tears are very common and are treated by restoring the torn ligament of the knee with a graft made of another tendon or ligament such as hamstring tendon, quadriceps tendon, or patellar tendon. Sometimes an allograft or cadaver tendon is used. This aids in stabilizing the knee and providing it with full range of motion.
- Open Reduction and Internal Fixation of Patellar Fracture (broken kneecap): Open reduction and internal fixation (ORIF) is a specific method used to repair fractures. When performed on the knee, this procedure is referred to as ORIF of the patella (kneecap). The surgeon will make an incision to expose the bone (open reduction). Once the surgeon sets the bone, he will then place plates with screws or metal wires to facilitate recovery (internal fixation). Your surgeon will then close the cuts with staples or stitches. This will help keep the bone in place while they heal and grow back together.
- Osteotomy: this surgery may be performed when a knee fracture does not heal correctly. During an osteotomy, your surgeon will take the weight off the damaged part of the knee by reshaping and repositioning the bone.
- Partial Knee Replacement: This surgery involves making a small incision and removing only the damaged or worn-out section of the knee and replacing it with a prosthesis. This leaves the healthy section of the knee in place. This type of surgery is recommended when the cartilage loss is limited to a small portion of the knee joint.
- Total Joint Replacement: In this procedure, both sides of the knee joint are replaced. The damaged or injured knee joints are detached and restored with a prosthesis on both sides restoring the knee alignment and function. Knee replacement is an option when knee joint damage cannot be repaired and intervenes with function and/or causes constant pain.
Postoperative care instructions may include:
- Elevating the affected knee above chest position to reduce swelling
- Use of crutches and/or wheelchair
- Getting up out of bed and walking while on crutches
- Use of medications and ice for pain relief
- Physical therapy to regain range of motion and muscle strength
- Follow up appointments and specific instructions on care of the surgical site
As with any surgery, some of the potential risks and complications of knee fracture surgery may include bleeding, infection, Damage to nerve and blood vessel damage, Stiffness and/ instability of the joint. When there is a failure to heal properly, repeat surgery may be necessary.