Patella Fracture Causes, Symptoms & Treatment Options

Your kneecap, or patella, connects muscles in your thigh (femur) to your shinbone (tibia). Located at the front of the knee, the patella acts like a shield protecting the knee joint and giving it strength to extend the leg. A patella fracture is a break in the kneecap. It usually results from a fall or a direct blow to the knee. For athletes, a knee fracture is a serious injury, causing pain, limiting your ability to play sports, and requiring medical attention.

Fractures to the kneecap usually result from a direct trauma to the front of the knee caused by a fall, car accident, or injury playing sports. A fracture can also occur from indirect stress due to bending or twisting.

The kneecap can fracture in different ways. When the broken bones remain in alignment — the bones stay in contact or are only slightly separated — it is called a nondisplaced or stable fracture. Another type, called a displaced fracture, occurs when the broken bones are separated and no longer line up.

A patella fracture causes sharp pain in the front of the knee. Swelling and bruising around the front of the knee can also occur. If the fracture is minimal (nondisplaced), you will often be able to bear weight and straighten the leg. With a more serious (displaced) fracture, you will not be able to bear weight on or straighten your leg.

Athletes with a suspected injury to their kneecap should immediately stop any further impact or exertion of the knee joint until they can be evaluated by a medical professional. This is important in helping you to avoid further injury. Patella fractures are often seen and diagnosed in an emergency room.

Your doctor will want to conduct a thorough interview by discussing your symptoms and medical history. These and other questions will help guide the diagnosis and determine treatment:

• When did pain in your knee begin?
• Did it follow an accident or sports injury?
• Is the pain over the kneecap?

Next, your doctor will conduct a physical examination to determine if there is swelling and bruising in the front of the knee. He/she will want to conduct a “straight leg raise test,” which will require you to try to raise your leg while lying down with your legs straight. Patients with a more serious, displaced patella fracture are unable to perform this movement.

After a physical examination, your doctor will order diagnostic tests. X-rays, taken from multiple angles, give doctors a full picture of the kneecap to determine the extent and location of the fracture and to check for other injuries. Other types of medical imaging, such as magnetic resonance imaging (MRI) and bone scans, are usually not necessary, but available if needed.

Treatment for a fractured patella will depend on the type of fracture. Non-displaced or minimally displaced fractures usually only require a cast or splint to prevent motion and keep broken bones in place so they can heal properly. This is often necessary for six weeks. Non-steroidal anti-inflammatory medications (NSAIDs) like ibuprophen may be prescribed for pain management. In some cases, you may not be able to place weight on your knee for several weeks.

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Patellar Fracture

Displaced fractures usually require surgery, because the bones in the knee are not close enough to heal properly. The surgeon will make a small incision over the front of the knee and realign the bones using screws and pins to keep the bone in place. If the kneecap is broken into many small pieces, your doctor may also remove some of the bone fragments.

The big question for athletes after a knee fracture is when they can return to play. With most minimal, or nondisplaced, fractures, the athlete is able to return to play in three to four months. In the case of a displaced fracture that requires surgery, the recovery is much longer and can take up to six months. Often, physical therapy is prescribed to help you regain motion and strength. You should not return to play until you have full range of motion and strength.