Gupta J, Harkin EA, O'Connor K, Enobun B, O'Hara NN, O'Toole RV. Surgical factors associated with symptomatic implant removal after patella fracture.
Injury 2022;
53:2241-2246. [PMID:
35341597 DOI:
10.1016/j.injury.2022.03.028]
[Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES
To determine whether certain types of fixation and other factors associated with the fixation could be identified that predict an increased risk of symptomatic implant removal.
METHODS
We conducted a retrospective cohort study at our urban academic level 1 trauma center. Patients aged ≥18 years who underwent operative fixation for patella fracture were included. The primary outcome was symptomatic implant removal after operative fixation.
RESULTS
Of the 186 study patients (mean age, 44 [SD 17] years, 65% male), 53 patients (28.5%) underwent symptomatic implant removal. Modifiable risk factors for symptomatic implant removal included the use of Kirschner (k)-wires (OR: 4.93; 95% CI, 1.89-14.10; p < 0.001), and a trend towards significance for implant prominence >5 mm (OR: 2.57; 95% CI, 0.93-7.93; p = 0.07). Symptomatic implant removal was also less likely in patients >45 years of age (OR: 0.14; 95% CI, 0.06-0.34; p < 0.01), of a racial minority (OR: 0.40; 95% CI, 0.17-0.88; p = 0.03), and a body mass index >25 kg/m2 (OR: 0.39; 95% CI, 0.18-0.84; p = 0.02). The final model demonstrated excellent prognostic performance, with an AUC of 0.83 (0.76-0.90).
CONCLUSION
We identified both modifiable and non-modifiable factors associated with symptomatic implant removal in patients with patella fractures. Surgeons should be aware that the use of k-wires and any implant prominence exceeding 5 mm might be associated with increased odds of symptomatic implant removal in patients with patella fractures.
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