Bourne identified risk factors for development of a periprosthetic patellar fracture. This can help identify a patient who may require closer monitoring or a change in management. The author is from the University of Western Ontario in Canada.


Risk factors for a periprosthetic fracture of the patella:

(1) osteoporosis

(2) osteolysis associated with the implant

(3) rheumatoid arthritis

(4) male gender

(5) a high level of activity

(6) an excessive range of motion

(7) patellar replacement with the implant

(8) central peg of the implant

(9) cementless implant

(10) posterior cruciate ligament substituting prosthesis

(11) inset design of the implant

(12) excessive or inadequate bone resection from the patella

(13) perforation of the anterior patella

(14) revision surgery

(15) malalignment of the patella or knee prosthesis

(16) subluxation of the patella

(17) devascularization of the patella


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