I fell on my knee and heard a crack. Do I need surgery?

Q. Over the weekend, I fell directly on my left knee and I heard a crack. I had severe pain and needed help walking.

At the emergency room, X-rays showed a patella fracture. I was given crutches and a long-leg Velcro brace and told to see an orthopedic surgeon. The doctor told me I needed surgery next week when the swelling goes down, otherwise I won’t be able to straighten my leg and walk again.

This sounded like aggressive treatment. What do you think?

A. The medical term for the kneecap is the patella. If a person sustains a fracture of the patella but the bones are still in place and the person can still extend their leg against gravity, this fracture can likely heal with a cast or long-leg brace held with the knee fully straight.

If the patella is displaced and the fracture goes on to heal in that position permanent, weakness and pain are likely. Therefore, a patella fracture that is not properly aligned requires surgery to fix the bones back together properly to restore a normal gait, normal strength, and decrease the risk of developing arthritis.

Even after surgery, a long-leg brace is usually necessary for several weeks followed by a rehab program to regain motion and strength. The prognosis after surgery is usually good.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net