Technique of Purse-String Patellectomy

Abstract

Summary: 

Some of the problems associated with patellectomy in the days before arthroscopy could be attributed to the surgical incisions and the trauma induced in removing the damaged patella. With the advent of arthroscopy, the decision to proceed to patellectomy is facilitated, which allows a minimally traumatic and more appropriate technique for removal of the patella to be used. After sharp tissue dissection and enucleation of the patella, the defect is closed circumferentially by using a pursestring suture technique. This takes up the slack created by the loss of the patella without restricting flexion or limiting extension. In the author's experience, 77% of 113 patellectomies yielded a satisfactory result. Although the patella should be preserved, if possible, patellectomy should not be considered a failure of treatment. Patellectomy should be considered a good salvage procedure, but one that will probably leave some weakness and requires a long time until the final result is achieved.