Aftercare | Patella fracture

Aftercare

The knee joint should only be flexed by a maximum of 60° within the first three weeks after the kneecap fracture – operation and by a maximum of 90° until the 6th week. The load on the operated leg should not exceed 20 kg at the beginning and should be increased to full load by the end of the sixth week. Deviations from this post-operative treatment scheme must be made in individual cases. X-ray examinations should be performed after 2, 4 and 6 weeks.

Prognosis

The smaller the damage to the patella, the better the long-term prognosis. Approximately 1/3 of all patients with a patella fracture have to expect load-dependent or permanent pain despite optimally treated patella fracture. The risk of permanent pain is particularly high in the case of multi-fragment fractures, comminuted fractures and fractures that can only be rejoined by forming steps.

The occurrence of patellar arthrosis (retropatellar arthrosis) is significantly increased after a patella fracture. There is also a risk of joint scarring (arthrofibrosis). If the patella fracture is treated surgically, it usually takes about 6 weeks until the fracture has healed enough to allow full weight bearing.

Of course, the duration of regeneration varies from patient to patient, so that the 6 weeks should only be seen as a rough guide. For example, it happens again and again that patients do not achieve freedom from symptoms beyond the 6 weeks. In some cases, the time until complete healing takes several years, and in exceptional cases patients even have to struggle with patellar complaints for the rest of their lives after a patella fracture.

In order to have a positive influence on the healing period of the patella fracture, the operative treatment is followed by rehabilitation. The rehabilitation, which is led by physiotherapists and sports therapists, includes exercises to strengthen the surrounding leg muscles and to stabilize the leg axis on the one hand and coordination exercises and the wearing of movement splints on the other hand. Depending on requirements, the duration can extend beyond a hospital stay of several days to a week.

In the form of very small exercise units, e.g. moving the feet, rehabilitation begins on the first day after the operation. The duration of the rehab depends on factors such as age, severity of the patella fracture and possible previous illnesses. In general, there is no prescribed length of stay, but discharge is usually scheduled for the 2nd day after surgery.

If complications occur during the operation or if the wound healing is difficult, the discharge date can be postponed for a few days at the discretion of the attending physician. The inability to work after a patella fracture is about 6 weeks. Depending on the activity to be performed, the inability to work can be longer, e.g. if work has to be performed in the kneeling position or is generally extremely stressful for the knees.