During total knee replacement, the patella is resected to a thickness of 10 mm from an original thickness of 24 mm. The remaining patellar bone thickness after resection is 14 mm. Which complication is most likely to occur from this error?
- A Patellar fracture ✓
- B Patellar clunk syndrome
- C Patellar overstuffing and anterior knee pain
- D Quadriceps tendon rupture
Correct answer: A. Patellar fracture
Explanation
Leaving less than 10–12 mm of residual patellar bone stock is the principal risk factor for periprosthetic patellar fracture. The resected bone should ideally maintain at least 12–15 mm of thickness to preserve structural integrity. Overstuffing (C) occurs when the composite thickness exceeds original thickness, causing quadriceps tension and anterior pain. Patellar clunk syndrome (B) is caused by fibrous nodule formation at the superior pole catching on the intercondylar box.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.