Nonsurgical Treatment of Patella Fractures
Doctors can sometimes treat people with a patella, or kneecap, fracture without surgery. A large tendon, called the quadriceps tendon, covers the patella and connects the thigh muscles to the lower leg bone. Doctors at NYU Langone may suggest one or more nonsurgical treatments for a patella fracture if the quadriceps tendon remains intact and the fracture is not displaced, meaning the patella has fractured but has not broken into many separate pieces.
Regardless of the type of patella fracture, doctors recommend using crutches or a wheelchair during the first week or two after an injury. This allows the bones to heal without having to bear weight, which may make an injury worse. Our doctors can provide you with crutches or a wheelchair.
Braces and Casts
For most patella fractures that don’t require surgery, our doctors work with NYU Langone orthotics specialists to provide a knee cast or brace that you wear for four to six weeks. Orthotics specialists ensure that the supportive device fits you properly. These devices immobilize the leg from the thigh to the shin, which allows the patella to heal correctly.
Your doctor may schedule follow-up visits once a week during the first two months after the injury to monitor the healing process. During these follow-up visits, a doctor may take new X-rays of the knee to see how well the bone is healing.
After your doctor sees evidence on an X-ray that the fracture has healed well enough to allow movement in the knee, the immobilizing cast or brace is replaced with a flexible brace, allowing the knee to bend. This typically occurs six to eight weeks after the injury, but the exact timeline depends on the severity of the fracture.
Electronic Bone Stimulation
As the fractured patella begins to heal, your doctor may recommend a technique called electronic bone stimulation. This painless therapy may help speed the rate of bone healing and takes place in the doctor’s office or at NYU Langone’s Bone Healing Center.
A doctor places a small electrode or electrodes—which are flat discs that conduct electricity—onto the skin near the fractured bone. These electrodes are connected to a machine that pulses a low electrical current through the patella. This technique jump-starts the healing process by stimulating proteins in bones to begin repairing cells at the site of injury.
As soon as you can bend your injured knee without pain, NYU Langone doctors recommend physical therapy. This may be one to six weeks after injury. Physical therapists at NYU Langone’s Rusk Rehabilitation can tailor a rehabilitation plan to help you build strength and flexibility in the knee and surrounding muscles. Physical therapy can also restore range of motion in your knee. Simple weight-bearing exercises, such as leg raises, can help to strengthen the muscles around the injured knee. Strong muscles improve mobility and also support the knee and protect it from another injury.
Your physical therapist may recommend incorporating simple stretching and strengthening movements into a home routine in between sessions. Physical therapy may continue once a week for six to eight weeks or until the patella fracture is healed completely.
Patella fractures can be painful. While the fracture heals, a doctor may recommend pain medication to make you more comfortable. For some people, an over-the-counter medicine, such as acetaminophen, works well. If knee pain is not alleviated by these medications, your doctor may prescribe a stronger pain medication for one or two weeks to help you get through the initial healing period and the start of physical therapy.