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Surgical factors associated with symptomatic implant removal after patella fracture. Injury 2022 Jun;53(6):2241-2246

Date

03/29/2022

Pubmed ID

35341597

DOI

10.1016/j.injury.2022.03.028

Scopus ID

2-s2.0-85127355791 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

OBJECTIVES: To determine whether certain types of fixation and other factors associated with the fixation could be identified that predict an increased risk of symptomatic implant removal.

METHODS: We conducted a retrospective cohort study at our urban academic level 1 trauma center. Patients aged ≥18 years who underwent operative fixation for patella fracture were included. The primary outcome was symptomatic implant removal after operative fixation.

RESULTS: Of the 186 study patients (mean age, 44 [SD 17] years, 65% male), 53 patients (28.5%) underwent symptomatic implant removal. Modifiable risk factors for symptomatic implant removal included the use of Kirschner (k)-wires (OR: 4.93; 95% CI, 1.89-14.10; p < 0.001), and a trend towards significance for implant prominence >5 mm (OR: 2.57; 95% CI, 0.93-7.93; p = 0.07). Symptomatic implant removal was also less likely in patients >45 years of age (OR: 0.14; 95% CI, 0.06-0.34; p < 0.01), of a racial minority (OR: 0.40; 95% CI, 0.17-0.88; p = 0.03), and a body mass index >25 kg/m2 (OR: 0.39; 95% CI, 0.18-0.84; p = 0.02). The final model demonstrated excellent prognostic performance, with an AUC of 0.83 (0.76-0.90).

CONCLUSION: We identified both modifiable and non-modifiable factors associated with symptomatic implant removal in patients with patella fractures. Surgeons should be aware that the use of k-wires and any implant prominence exceeding 5 mm might be associated with increased odds of symptomatic implant removal in patients with patella fractures.

Author List

Gupta J, Harkin EA, O'Connor K, Enobun B, O'Hara NN, O'Toole RV

Author

Elizabeth A. Nolte MD Assistant Professor in the Orthopaedic Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Bone Wires
Female
Fracture Fixation, Internal
Fractures, Bone
Humans
Knee Injuries
Male
Patella
Retrospective Studies
Treatment Outcome