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Total Patellectomy



- Discussion:
    - total patellectomy should be reserved for alvage treatment of frxs that cannot be fixed or treated with partial patellectomy;
    - indications:
          - severely comminuted frx w/ separation of fragments;
          - no major articular fragment remaining intact;
    - defect resulting from removal of patella can be closed in a vertical, purse-string, or transverse fashion;
- Post Op:
    - after operative repair, these pts should be managed w/ application of cylinder or above-the-knee cast for six weeks;
           - cast is then removed & ROM and strengthening exercises are begun;
    - loss of ROM, loss of knee extensor strength, extension lag, and persistent discomfort are common after total patellectomy