Non-metallic implant for patellar fracture fixation: A systematic review

Camarda, Lawrence; Morello, Salvatore; Balistreri, Francesco; D’Arienzo, Antonio; D’Arienzo, Michele

doi:10.1016/j.injury.2016.05.039

Cited by 55 publications

(44 citation statements)

References 21 publications

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“…The study with the lowest reported rate of irritation and subsequent implant removal utilized a cannulated screw and cable construct, which was demonstrated to be superior to the traditional modified tension band technique. 4 Alternatively, utilization of suture-based techniques also results in a marked reduction in soft tissue irritation 10 and lessens the need for reoperation. 7 Fixation with biodegradable materials is another approach, but not as widely available or feasible.…”

Section: Discussionmentioning

confidence: 99%

Comparing 3 Different Techniques of Patella Fracture Fixation and Their Complications

Shea

Tam

et al. 2019

Geriatr Orthop Surg Rehabil

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Introduction: Patella fractures managed by fixation with metal implants often cause local soft tissue irritation and necessitate implant removal. An alternative is to utilize suture-based fixation methods. We have adopted suture and hybrid fixation in the routine management of patella fractures. Here, we compare the results of 3 fixation techniques. Materials and Methods: Eighty-seven eligible patients underwent patella fracture fixation over a 3-year period. As determined by fracture configuration, patients received (1) suture fixation (transosseous sutures and figure-of-eight tension banding with FiberWire), (2) hybrid fixation (transosseous FiberWire sutures and metal tension banding), or (3) metal fixation. Primary outcome measures included reoperation rate and soft tissue irritation. Secondary outcomes included surgical complications, radiological, and functional parameters. Results: Reoperation rate was highest for metal fixation (25/57, 43.9%) and lowest for suture fixation (2/13, 15.4%). Soft tissue irritation necessitating implant removal was the predominant reason for reoperation and was significantly less prevalent following suture fixation (1/13, 7.7%, P < .01). Hybrid fixation resulted in similar rates of soft tissue irritation (6/17, 35.3%) and implant removal (7/17, 41.2%) as compared to metal fixation. There was a significant increase in patella baja (13/17, 76.5%) and reduction in Insall-Salvati ratio (0.742; 95% confidence interval: 0.682-0.802) following hybrid fixation as compared to the other 2 fixation methods ( P < .05). Discussion: Suture fixation results in the least amount of soft tissue irritation and lowest reoperation rate, but these advantages are negated with the addition of a metal tension band wire. Hybrid fixation also unbalances the extensor mechanism. Conclusion: Patients should be counseled as to the expected sequelae of their fixation method. Suture fixation is the favored means to fix distal pole fractures of the patella. An additional metal tension band loop may confer additional stability but should be applied with caution.

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Section: Discussionmentioning

confidence: 99%

Comparing 3 Different Techniques of Patella Fracture Fixation and Their Complications

Shea

Tam

et al. 2019

Geriatr Orthop Surg Rehabil

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“…[3][4][5][6][7][8][9][10] The benefits of using suture tape augmentation include the theoretically reduction in postoperative complications, including wound healing and hardware pain. 11 Over the years, new techniques have been tried out using various non-metallic implants that could reduce the rate of complications related to the synthesis media. 12,13 The suture tape, as reported by the patients at follow-up controls, does not seem to cause any discomfort due to its presence, unlike metal implants, which in some cases cause pain and discomfort such as to motivate the patient to request a second surgery for removal ( Table 3).…”

Section: Discussionmentioning

confidence: 99%

Patellar Fracture Fixation Using Suture Tape Cerclage

Monaco¹,

Bruni²,

Daggett

et al. 2020

Arthroscopy Techniques

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Transverse patellar fractures are a relatively common injury and typically require surgical fixation. An adequate restoration of patella integrity is essential for proper functioning of the extensor mechanism of the knee and for the prevention of patellofemoral osteoarthritis. Currently, the treatment of transverse fractures of the patellar bone involves several surgical techniques, most of which involve the use of metallic implants. Despite good clinical results following surgery, numerous complications exist, including primarily symptomatic hardware following surgical treatment. The purpose of this article is to describe the technique for treatment of a transverse patellar fracture using a high-resistance tape (FiberTape; Arthrex) and a tensioner (Arthrex) instead of traditional metallic implants.

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“…Thus, this technique was modified in recent years. Non-absorbable polyester braided sutures are also applied to instead of wiring cable [15–18]. In addition, the hybrid technique of cannulated screws and tension bands is proposed, two cannulated screws instead of Kirschner wires were inserted through by modified tension band wiring.…”

Section: Discussionmentioning

confidence: 99%

A novel three-dimensional strapping reduction for the treatment of patellar fractures

Jiang

Kotian

et al. 2019

J Orthop Surg Res

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Objective This study aimed to investigate the effectiveness of a three-dimensional strapping reduction in the treatment of patellar fractures. Methods Between January 2015 and June 2017, a total of 56 patients were randomly allocated to the three-dimensional strapping reduction group (trial group) and towel clamp reduction group (control group). There were no significant differences in age, gender, injury side, the interval time from injury to surgery, fracture pattern, and cause of injury ( P > 0.05). The operation time, fluoroscopy time, bone union time, postoperative Hospital for Special Surgery (HSS) scores, and complications were recorded and analyzed. Results All incisions achieved primary union. All patients in both groups completed a follow-up with an average of 12.5 months (range 11–15 months). Both operation time and fluoroscopy time in the trial group were significantly shorter than those in the control group ( P < 0.001). All patellar fractures achieved bone union, and there was no significant difference in bone union time between the two groups ( P > 0.05). Bone nonunion, infection, and fixation failure were not found in both groups. HSS scores of the trial group (90.9 ± 4.2) were higher than those of the control group (86.6 ± 5.2) ( P < 0.01). Conclusion Compared with towel clamp reduction, the three-dimensional strapping reduction in the treatment of patellar fractures has advantages of shorter operation time and fluoroscopy time, better knee function after surgery, and satisfactory fracture healing.

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Non-metallic implant for patellar fracture fixation: A systematic review

Cited by 55 publications

References 21 publications

Comparing 3 Different Techniques of Patella Fracture Fixation and Their Complications

Comparing 3 Different Techniques of Patella Fracture Fixation and Their Complications

Patellar Fracture Fixation Using Suture Tape Cerclage

A novel three-dimensional strapping reduction for the treatment of patellar fractures

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