Case report: The nest technique for management of a periprosthetic patellar fracture with severe bone loss

Periprosthetic patellar fracture with marked loss of bone stock presents a significant problem in total knee arthroplasty. Treatment outcomes are often unsatisfying and may lead to disruption of the extensor mechanism of the knee. We present a patient with a Type Illb periprosthetic patellar fracture treated by a novel approach. Three Steinmann pins were used to reduce the patella and form scaffold for bone graft and a patellar button was cemented into the construct. At 7 years followup, the patient has maintained excellent range of motion, reports no knee pain, has healed the patella fracture, and has restored patellar bone stock. (C) 2008 Elsevier B.V. All rights reserved.