{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T02:16:23Z","timestamp":1767665783512},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"01","funder":[{"name":"Asklepios Kliniken Hamburg GmbH"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Patellar fractures account for approximately 1% of all skeletal fractures. These fractures are rare; however, because of the crucial function of the patella in the extensor mechanism of the knee, they may lead to serious impairment. New data are revealing functional impairment remains common even with improved surgical techniques. The aim of this study was to assess the functional outcomes of patients after revision surgery in cases of secondary fracture dislocation or persistent articular incongruity. This study included 16 patients with a mean age of 51.8 years (range: 16\u201385 years) with a mean follow-up of 35.1 months. According to the AO\/OTA classification, 15 patients had a C-type fracture, including 10 patients with C3 fracture. Thirteen patients were initially treated with tension band wiring via K-wires or cannulated screws. Revision surgery was performed because of persistent articular incongruity in five patients and secondary fracture dislocation or refracture in 11 patients. We analyzed pain (visual analog scale [0\u201310]), satisfaction, range of motion (ROM), B\u00f6stman's score, Lysholm's score, and knee injury and osteoarthritis outcome score (KOOS) after revision surgery and could extract follow-up data from 15 patients. Mean pain score at rest was 0.57 (range: 0\u20133.5) and on exertion 2.79 (range: 0\u20138). The measurement of the ROM of the affected knee compared with that of the opposite knee revealed complete extension. Mean flexion was 123\u2009degrees, in the corresponding knee it was 136\u2009degrees (p\u2009=\u20090.05). The mean postoperative B\u00f6stman's and Lysholm's scores were 25.11 (good, maximum: 30) and 78.67 (moderate, maximum: 100), respectively. KOOS was as follows: symptoms, 66.8 points; pain, 77.55 points; activity of daily living (ADL), 75.67 points; and quality of life, 56.25 points. The results of this study suggested that early revision surgery after failure of primary osteosynthesis with secondary anatomic reconstruction and good radiological results leads to satisfactory functional outcomes with persistent functional deficits.<\/jats:p>","DOI":"10.1055\/s-0039-1692673","type":"journal-article","created":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T22:51:20Z","timestamp":1562712680000},"page":"080-086","source":"Crossref","is-referenced-by-count":12,"title":["Functional Outcomes of Revision Osteosynthesis after Failure of Surgical Treatment of Patellar Fractures"],"prefix":"10.1055","volume":"34","author":[{"given":"Elena Caroline","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl-Heinz","family":"Frosch","sequence":"additional","affiliation":[{"name":"Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Hamburg, Germany"},{"name":"Department of Trauma and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf UKE, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2019,7,9]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/ort.1972.43.suppl-143.01","article-title":"Fracture of the patella. A study of 422 patellar fractures","volume":"143","author":"A Bostr\u00f6m","year":"1972","journal-title":"Acta Orthop Scand Suppl"},{"issue":"158","key":"ref2","first-page":"180","article-title":"Transverse fractures of the patella","author":"P A Lotke","year":"1981","journal-title":"Clin Orthop Relat Res"},{"issue":"10","key":"ref3","doi-asserted-by":"crossref","first-page":"2065","DOI":"10.1016\/j.injury.2016.06.032","article-title":"Adult native knee extensor mechanism ruptures","volume":"47","author":"I P Pengas","year":"2016","journal-title":"Injury"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s13244-016-0535-0","article-title":"Imaging of patellar fractures","volume":"8","author":"M Jarraya","year":"2017","journal-title":"Insights Imaging"},{"issue":"04","key":"ref5","first-page":"233","article-title":"The computed tomographic evaluation of patellofemoral joint in patellar fractures treated with open reduction and internal fixation","volume":"38","author":"I T Benli","year":"1992","journal-title":"Kobe J Med Sci"},{"issue":"S 01","key":"ref6","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/BOT.0000000000001063","article-title":"Fracture and dislocation classification compendium - 2018","volume":"32","author":"E G Meinberg","year":"2018","journal-title":"J Orthop Trauma"},{"issue":"01","key":"ref7","first-page":"27","article-title":"[Classification of patellar fractures]","volume":"87","author":"M Speck","year":"1994","journal-title":"Z Unfallchir Versicherungsmed"},{"key":"ref8","volume-title":"AO Principles of Fracture Management; Vol. 1: Principles, Vol. 2: Specific Fractures. 3 ed","author":"R E Buckley","year":"2017"},{"issue":"06","key":"ref9","first-page":"638","article-title":"[Proper and improper tension band fixation exemplified by patellar fracture]","volume":"68","author":"R Labitzke","year":"1997","journal-title":"Chirurg"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1302\/0301-620X.67B3.3997951","article-title":"Results of surgical treatment of patellar fractures","volume":"67","author":"B Levack","year":"1985","journal-title":"J Bone Joint Surg Br"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"215","DOI":"10.2106\/00004623-198062020-00007","article-title":"Efficacy of various forms of fixation of transverse fractures of the patella","volume":"62","author":"M J Weber","year":"1980","journal-title":"J Bone Joint Surg Am"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1097\/00005373-199509000-00007","article-title":"Open fractures of the patella: long-term functional outcome","volume":"39","author":"J B Catalano","year":"1995","journal-title":"J Trauma"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1097\/00005131-199707000-00009","article-title":"Biomechanical evaluation of current patella fracture fixation techniques","volume":"11","author":"J E Carpenter","year":"1997","journal-title":"J Orthop Trauma"},{"issue":"05","key":"ref14","first-page":"401","article-title":"[Fractures of the patella]","volume":"113","author":"M Wild","year":"2010","journal-title":"Unfallchirurg"},{"issue":"06","key":"ref15","first-page":"509","article-title":"[Plate osteosynthesis of patellar fractures]","volume":"29","author":"E C M\u00fcller","year":"2017","journal-title":"Oper Orthop Traumatol"},{"issue":"09","key":"ref16","doi-asserted-by":"crossref","first-page":"e305","DOI":"10.1097\/BOT.0000000000000309","article-title":"Biomechanical assessment of locked plating for the fixation of patella fractures","volume":"29","author":"S Wurm","year":"2015","journal-title":"J Orthop Trauma"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s10039-015-0081-x","article-title":"Patellafrakturen","volume":"17","author":"S Wurm","year":"2015","journal-title":"Trauma Berufskrankheit"},{"issue":"09","key":"ref18","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1007\/s00113-016-0213-1","article-title":"Die Plattenosteosynthese der Patellafraktur\u2013Technik und erste Ergebnisse einer prospektiven Studie","volume":"120","author":"A Ellwein","year":"2017","journal-title":"Der Unfallchirurg"},{"key":"ref19","first-page":"Doc01","article-title":"Current concepts review: fractures of the patella","volume":"5","author":"C Gwinner","year":"2016","journal-title":"GMS Interdiscip Plast Reconstr Surg DGPW"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/0020-1383(81)90238-2","article-title":"Comminuted displaced fractures of the patella","volume":"13","author":"O B\u00f6stman","year":"1981","journal-title":"Injury"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/BF02498719","article-title":"Fractures of the patella treated by operation","volume":"102","author":"O B\u00f6stman","year":"1983","journal-title":"Arch Orthop Trauma Surg"},{"issue":"07","key":"ref22","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1097\/BOT.0b013e318228c1a1","article-title":"Functional outcomes after operatively treated patella fractures","volume":"26","author":"C T LeBrun","year":"2012","journal-title":"J Orthop Trauma"},{"issue":"14","key":"ref23","doi-asserted-by":"crossref","first-page":"e96","DOI":"10.2106\/JBJS.L.00012","article-title":"Outcomes after operative fixation of complete articular patellar fractures: assessment of functional impairment","volume":"95","author":"L E Lazaro","year":"2013","journal-title":"J Bone Joint Surg Am"}],"container-title":["The Journal of Knee Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-1692673.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,3]],"date-time":"2021-01-03T23:40:20Z","timestamp":1609717220000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-1692673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,9]]},"references-count":23,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2021,1,3]]},"published-print":{"date-parts":[[2021,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-1692673","relation":{},"ISSN":["1538-8506","1938-2480"],"issn-type":[{"value":"1538-8506","type":"print"},{"value":"1938-2480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,9]]}}}