Do I need surgery for my broken kneecap, and what does it involve?

When an operation is recommended

• The fragments have pulled apart, because the quadriceps keeps pulling the top piece upwards
• There is a step in the cartilage surface behind the kneecap, which would wear the joint if left
• The leg cannot be straightened actively, meaning the extensor mechanism is broken
• The fracture is in many pieces (comminuted) or is an open fracture with a wound

How the kneecap is fixed

The operation is done under general or spinal anaesthesia, through an incision over the front of the knee. The fragments are lined up so the joint surface is as smooth as possible, then held in place.

Common methods include tension band wiring, where wires and pins convert the pull of the thigh muscle into compression across the fracture; screws, sometimes combined with wiring; and low-profile plates, particularly for fractures in many pieces. Very small fragments at the lower tip may be removed and the tendon reattached to the remaining bone. Most patients stay in hospital for one or two nights.

After the operation

A brace protects the repair. Many patients are allowed to put weight on the leg with the knee locked straight, using crutches. Bending is introduced in stages over the first six weeks or so, guided by the stability achieved in surgery and follow-up X-rays. Physiotherapy then focuses on bending, quadriceps strength and walking normally.

The metalwork lies just under the skin and can become uncomfortable, especially when kneeling. A second, smaller operation to remove it after the bone has healed is fairly common.

Planning surgery in Doha

Fracture fixation is usually done within days of injury, once swelling and the skin allow. At Aman Hospital, Dr. Gelber reviews your X-rays and, where needed, a CT scan to plan the fixation, explains the expected recovery for your work and family life, and arranges physiotherapy from the start.