Two types of surgery may be done to repair a fractured kneecap:
Open reduction-internal fixation (ORIF) surgery - The surgeon opens the skin and puts the broken bones back together with metal wires, pins or screws. Broken pieces of bone too small to be fixed are removed. If the kneecap is so severely fractured that it cannot be repaired, it may be partially or totally removed.
After the bones have been joined, the opening is closed, a sterile dressing is put over the area and the knee is put in a cast or other device so it cannot move while it heals.
Sometimes, especially in patients who are thin, the wires, pins or screws can be irritating. If so, the devices will be removed after your kneecap has fully healed.
Full or partial patellectomy - This two-hour procedure removes all or part of the kneecap. If your surgeon finds that the break is too severe to repair, he or she will remove the damaged pieces of bone.
The surgery preserves the quadriceps tendon above the kneecap, the patellar tendon below and other soft tissues around the kneecap. After this surgery, you will be able to extend your knee, but the strength of the extension will be weaker.
Once your kneecap has healed, making the muscles around your knee stronger can help avoid further injury. Playing contact sports or doing other activities that put stress on your knee can increase the risk of having another injury to the kneecap. You should avoid these activities or use a kneepad to cushion the blow when playing contact sports.
Physical therapy, learning ways to spare your knee stress and strengthening and conditioning your leg muscles on an on-going basis can help prevent more injuries to the knee.
Your best exercise options are low-impact and non-weight-bearing, like stationary bikes and certain weightlifting programs, so that the knees do not have to absorb shock.