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Aug 14, 2023

Walking after patellar fracture: Timing, treatment, and more

The patella, or kneecap, is a small, triangular bone that protects the front of the knee. People who fracture their patella may have difficulty walking or straightening their leg. Most people can

The patella, or kneecap, is a small, triangular bone that protects the front of the knee. People who fracture their patella may have difficulty walking or straightening their leg. Most people can return to typical activities within 3–6 months.

Only about 1% of all fractures are patella fractures, and males are more likely to experience this type of fracture. Most patella fractures happen when a person falls on their knees heavily or smashes their legs against the dashboard in a vehicle accident.

The American Academy of Orthopaedic Surgeons (AAOS) explains that the patella can break in different ways, ranging from hairline cracks to complete shattering. If pieces of bone move out of place, the person may need surgery and their recovery time may be longer.

Most people find it too painful to put weight on their injured knee immediately after breaking it. Doctors usually recommend gentle exercises as soon as the pain subsides.

This article outlines what to expect while recovering from a fractured patella. It also looks at the different surgical and nonsurgical treatments and how quickly a person can be active again.

Most people wear a hinged knee brace after injury or surgery. This holds the leg straight and immobilizes it while keeping the fracture stable.

Some people may be able to put weight on their leg as soon as the pain is bearable while wearing a brace, but some fractures cannot bear weight for 6–8 weeks. Doctors will explain the extent of a person’s injury and advise them on when to attempt this.

Complicated fractures such as open fractures — in which bone fragments stick out of the person’s skin — take longer to heal because the surrounding soft tissue also sustains damage.

Most fractures are painful for a few days to a few weeks.

Learn about common pain relievers here.

Anatomically, the patella connects to the thigh muscles, or quadriceps femoris. These muscles help straighten the leg and play a major role in walking. A break in this connection may mean that a person cannot walk or straighten their knee.

According to the AAOS, other symptoms include bruising, swelling, and pain around the front of the knee.

Learn more about fractures here.

If the person has a stable fracture, in which the pieces of the broken bone are still in contact, doctors may recommend nonsurgical treatment such as a cast, brace, or splint to keep the leg straight and immobile.

However, there is no golden rule about when it is safe to start walking or putting weight on the damaged knee, as it depends on the type of fracture. Some people may be able to walk while wearing a brace or cast, while doctors may tell others not to put any weight on the limb for 6–8 weeks.

The AAOS states that most people can manage their pain with over-the-counter (OTC) pain medications. It can also be helpful for a person to rest, keep the leg elevated, and — if the leg is not in a cast — use ice.

Doctors may prescribe stronger pain medication, such as an opioid, if a person’s pain is severe.

Many people with a fractured patella have bruises and cuts in the soft tissue surrounding the broken bone. If these injuries are minor, people can treat them by washing the area to remove debris and then applying an antiseptic cream to any cuts.

How active a person can be will depend on the severity of the fracture. Guidelines published in Swiss Medical Weekly in 2020 say that some people can start gentle physical therapy after about 10 days. However, a doctor can give tailored advice depending on a person’s injury.

Most doctors encourage people to wear a leg brace when putting weight on the knee. Early exercises may simply involve touching the toes to the floor, gradually building up to bearing weight.

Most people can start resistance exercises after about 6 weeks.

Surgery for a patella fracture varies depending on the type of fracture. Surgeons sometimes use plates, screws, and wires to reconstruct the knee, removing small parts of the bone if necessary.

Doctors may prescribe strong pain medication after surgery, but most people can manage their pain with OTC remedies. Keeping the leg elevated may also help.

Doctors usually recommend wearing a hinged knee brace after surgery. A doctor or physical therapist may also suggest some simple movements to:

Learn more about physical therapy here.

Some fractured patellas do not knit together properly when healing. People may need further surgery to correct this.

Some surgeries involve using screws, wires, and plates to hold the pieces of bone together. These items may become loose or fail in another way and need replacing.

Sometimes, people find the metal plates and screws uncomfortable, especially when kneeling. Doctors may recommend further surgery about a year later to remove the hardware.

Other possible complications include infections and continued pain.

Learn about bone fracture repairs here.

The Arthritis Foundation explains that some people develop chondromalacia patella after fracturing their kneecap. This happens when the cartilage under the kneecap breaks down and the bones rub against each other.

Without proper treatment, people may develop osteoarthritis.

Many people experience ongoing loss of knee movement, particularly of the ability to bend and straighten the knee. However, this does not usually prevent a person from going about their daily life.

People may find that their thigh muscles feel weaker than before the injury. They may feel more stable when wearing a brace.

Knee braces can also help if people are experiencing chronic pain.

Most people seek help immediately after fracturing their patella, as they cannot put any weight on the leg or straighten it. They first contact a doctor at an emergency room.

Anyone with pain and swelling around their knee after a fall or traffic accident should consult a doctor as soon as possible, especially if they cannot stand with any weight on that leg.

Doctors can sometimes feel the fracture through the skin, especially if the bone is displaced, but they will order X-rays to confirm their diagnosis.

Most people recover fully from a fractured patella after the initial healing process. However, this can take several months.

Some people experience ongoing stiffness, and scar tissue may interfere with the knee’s range of movement.

A fractured patella is a serious injury that needs medical attention to immobilize the knee and stabilize the joint.

The kneecap can fracture in different ways, and the type of treatment depends on the severity and nature of the break. People with hairline cracks to their patella may recover more quickly than those with a shattered kneecap.

Most people can start putting weight on their leg as soon as the pain subsides. However, doctors will give individual advice based on a person’s injury.