A Novel Transosseous Suture Repair Technique for Inferior Pole Patella Fractures Using a Suture Anchor: A Case Series and Technical Note.

Objectives: Fractures located at the inferior pole of the patella pose challenges in terms of fracture fixation, primarily due to inadequate bone quality at the lower pole and typically limited options for secure fixation. This study introduces a novel approach that involves employing the Krackow suture technique on the patellar tendon, followed by a longitudinal transosseous and upside-down fixation at the superior aspect of the patella using a suture anchor to address this challenge. Methods: A retrospective cohort case series was conducted at a single center, involving ten patients with fractures at the lower pole of the patella. Follow-up assessments were performed for a minimum of six months to observe postoperative gap formation and evaluate bony union. Knee motion, pain, function, and any intra- and postoperative complications were documented throughout the follow-up periods. Results: All patients exhibited complete bone union without gap formation six months postoperatively, accompanied by a regained full range of motion without any functional limitations. No instances of postoperative anterior knee pain, refracture of the inferior patellar pole, or other complications were reported during the follow-up period. Conclusion: The innovative technique involving longitudinal transosseous and upside-down suture anchor repair for the management of inferior patellar pole fractures is a straightforward and easily executable surgical procedure. This method offers stable fixation and yields favorable functional outcomes.