- Discussion:
- total patellectomy should be reserved for alvage treatment of frxs that cannot be fixed or treated with partial patellectomy;
- indications:
- severely comminuted frx w/ separation of fragments;
- no major articular fragment remaining intact;
- defect resulting from removal of patella can be closed in a vertical, purse-string, or transverse fashion;
- Post Op:
- after operative repair, these pts should be managed w/ application of cylinder or above-the-knee cast for six weeks;
- cast is then removed & ROM and strengthening exercises are begun;
- loss of ROM, loss of knee extensor strength, extension lag, and persistent discomfort are common after total patellectomy