Result of Surgical Treatment of Pseudoarthrosis of the Patella.

Abstract

Objective: To assess the surgical treatment of pseudoarthrosis of the patella in the orthopaedic and traumatology unit of the Teaching Hospital of Treichville (Abidjan- Côte d\'Ivoire).
Methods: Six patients (3 males and 3 females) of 43 years average age (from 36 to 48 years old) with pseudoarthrosis of the patella were admitted in the unit. The lesions were caused by road traffic accident in one patient and domestic accidents in 5 patients.
The average time before reporting to the hospital for consultation was 130 days [93- 181 days]. A pseudoarthrosis was due to failure of an initial osteosynthesis and 5 were due to late treatment subsequent to traditional bone setting. In every case, surgery was
done with tension band wiring, without graft (4 cases) and associated with cancellous bone graft in two cases. All the patients were reviewed at an average time of 44 months later
[range from 28 to72 months] and examined according to Bostman score.
Result: No immediate and secondary post operative complication was observed. We noted 2 cases of osteopenia of the patella, a patellofemoral arthrosis in 4 cases, and a lower post
operative patella in every patient with an average index of Caton- Deschamps at 0.34 cm (From 0.15 to 0.51 cm) were observed. Two malunion of fractures and an amyotrophy compared with healthy thigh were observed. The average Bostman functional
score was excellent (28.83 points/30).
Conclusion: Pseudoarthrosis of the patella in our centre is the consequence of traditional bone setting or late treatment. Osteosynthesis with or without graft of these lesions allow bone union despite a functional insufficiency which does not disturb the patient\'s physical activity.

Keywords: patella, pseudoarthrosis

Nigerian Journal of Orthopaedics and Trauma Vol. 7 (1) 2008 pp. 10-12