Management of Patella Fracture Nonunion and Large Bone Defect After Bone-Patellar Tendon-Bone Autograft: A Case Report

JBJS Case Connect. 2022 Sep 1;12(3). doi: 10.2106/JBJS.CC.22.00251. eCollection 2022 Jul 1.


Case: A 32-year-old patient was diagnosed with a vertical patella fracture nonunion after a bone-patellar tendon-bone (BTB) anterior cruciate ligament reconstruction. In addition, a 1 × 2 × 1 cm patellar bone defect was noticed at the graft harvesting site. The patient was treated surgically with open reduction and internal fixation and iliac crest bone autograft which resulted in fracture union.

Conclusion: Many intraoperative and postoperative risk factors for iatrogenic patella fracture when harvesting BTB autograft were identified. Surgeons should be aware of technical skills needed to prevent this complication and should treat the fracture appropriately to avoid nonunion and optimize the outcome.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anterior Cruciate Ligament / surgery
  • Autografts
  • Fractures, Bone* / etiology
  • Fractures, Bone* / surgery
  • Fractures, Ununited* / complications
  • Fractures, Ununited* / surgery
  • Humans
  • Knee Injuries* / surgery
  • Patella / surgery
  • Patellar Ligament* / transplantation