Fracture Care · Knee, leg & ankle
Patella (kneecap) fracture
Patella Fracture (Broken Kneecap) — Open Reduction and Internal Fixation (ORIF)
The condition
The patella (kneecap) is a bone at the front of the knee that links the thigh muscle to the shin bone and lets you straighten the leg. It usually breaks from a fall directly onto the knee or a forceful pull of the thigh muscle. A displaced break causes pain, swelling, and trouble straightening the knee or walking.
The surgery
This is a typically outpatient surgery through an incision over the front of the knee. The pieces are put back together, restoring the smooth joint surface, and held with pins and wire, screws, sutures, or a small plate. If a small piece is shattered, it may be removed and the tendon reattached to the rest of the kneecap. The final plan is determined during surgery.
Recovery at a glance
- Brace & weight
- Full weight right away with crutches and the brace locked straight for walking and sleep for 6 weeks. Brace and crutches are then weaned over 2 weeks.
- Motion
- During PT exercises: bending to 90° for 4 weeks, then 120° by 6 weeks (less if part of the kneecap was removed). Stationary bike from 6 weeks. In some cases, bending will be delayed longer
- Daily life
- Desk work often within 1–2 weeks. Leg press and squats to 90° start between 8 and 10 weeks. No driving while taking narcotic pain medication.
- Running
- Typically ~4 months, once thigh strength reaches 80% of the other side.
- Sports
- Agility and sports at 5–6 months, after strength and hop testing.
A general guide. Your restrictions and timeline may change based on what is found and done at surgery.
Risks & benefits
Benefits: Restoring the kneecap lets you straighten the knee with strength again and walk normally. Risks are uncommon and include infection, blood clots, hardware irritation (common; often removed later), the bone healing slowly or not at all, weakness straightening the knee, pain with kneeling, kneecap arthritis over time, injury to nearby structures (such as nerves, blood vessels, or cartilage), stiffness, persistent pain, and the need for further surgery. These will be reviewed with you in detail before surgery.
Patient Surgical Information
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Before & after every surgery