---
title: "Locking plate fixation versus tension-band wiring for displaced patellar fractures: randomized mul"
id: "pubmed-42674573"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42674573"
content_type: "clinical_feed_article"
specialty: "General"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42674573/"
doi: "10.1302/0301-620X.108B9.BJJ-2026-0517.R1"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Locking plate fixation versus tension-band wiring for displaced patellar fractures: randomized mul
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42674573
- **Specialty:** [General](https://medichelpline.com/clinical-feed/general.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42674573/)
- **DOI:** [10.1302/0301-620X.108B9.BJJ-2026-0517.R1](https://doi.org/10.1302%2F0301-620X.108B9.BJJ-2026-0517.R1)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Study aim: compare clinical outcomes of **locking plate fixation** with **tension-band wiring** for adults requiring surgery for displaced patellar fractures. - Design: multicentre, patient- and assessor-blinded randomized controlled trial with 122 participants allocated 1:1 and intention-to-treat analysis. - Primary outcome: patient-reported knee function measured by five subscales of the **KOOS** at 12 months; predefined superiority required statistically significant differences in at least three KOOS subscales exceeding minimal clinically important differences (pain 10, symptoms 9, ADL 6, sport/recreation 10, QoL 10). - Follow-up: 12 months; completion rates reported as 57/63 (90.5%) in the locking plate group and 52/59 (88.1%) in the tension-band wiring group. - Key results: **locking plate fixation** produced statistically significant and clinically meaningful improvements in three KOOS subscales at 12 months: symptoms (mean difference −10.4, 95% CI −16.4 to −4.4), sport and recreation (−14.1, 95% CI −24.7 to −3.4), and quality of life (−10.9, 95% CI −19.0 to −2.7). - Secondary and safety signals: the abstract states that removal of hardware, failure of fixation, and reoperation occurred more frequently (text truncated); specific counts, rates, and additional secondary outcome results were not reported in the provided source excerpt. - Conclusions: Within the 12-month timeframe, locking plate fixation showed superior patient-reported outcomes on multiple **KOOS** domains compared with tension-band wiring. Full details on complication rates and other secondary outcomes were not available in the provided excerpt.
## Clinical Analysis & Structured Key Points
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[Trial Site investigators](https://pubmed.ncbi.nlm.nih.gov/?term=Trial+Site+investigators%5BCorporate+Author%5D); [Jan Duedal Rölfing](https://pubmed.ncbi.nlm.nih.gov/?term=R%C3%B6lfing+JD&cauthor_id=42674573)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#full-view-affiliation-8 "Aarhus University Hospital, Aarhus, Denmark."), [Rasmus Jorgensen](https://pubmed.ncbi.nlm.nih.gov/?term=Jorgensen+R&cauthor_id=42674573)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#full-view-affiliation-9 "Aalborg University Hospital, Aalborg, Denmark."), [Jens Traerup](https://pubmed.ncbi.nlm.nih.gov/?term=Traerup+J&cauthor_id=42674573)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#full-view-affiliation-9 "Aalborg University Hospital, Aalborg, Denmark."), [Anne Mette Kold Stausholm](https://pubmed.ncbi.nlm.nih.gov/?term=Stausholm+AMK&cauthor_id=42674573)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#full-view-affiliation-9 "Aalborg University Hospital, Aalborg, Denmark."), [Luis Ferreira](https://pubmed.ncbi.nlm.nih.gov/?term=Ferreira+L&cauthor_id=42674573)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#full-view-affiliation-9 "Aalborg University Hospital, Aalborg, Denmark."), [Mohammed Adel Al-Bayati](https://pubmed.ncbi.nlm.nih.gov/?term=Al-Bayati+MA&cauthor_id=42674573)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#full-view-affiliation-9 "Aalborg University Hospital, Aalborg, Denmark."), [Mette Rosenstand](https://pubmed.ncbi.nlm.nih.gov/?term=Rosenstand+M&cauthor_id=42674573)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#full-view-affiliation-9 "Aalborg University Hospital, Aalborg, Denmark."), [Rikke Serritslev](https://pubmed.ncbi.nlm.nih.gov/?term=Serritslev+R&cauthor_id=42674573)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#full-view-affiliation-10 "Kolding Regional Hospital, Kolding, Denmark.") Affiliations Expand ### Affiliations * 1 Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark. * 2 Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark. * 3 Department of Orthopaedic Surgery, Randers Regional Hospital, Randers, Denmark. * 4 Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark. * 5 Department of Orthopaedic Surgery, Kolding Hospital, Kolding, Denmark. * 6 Department of Orthopaedic Surgery, Viborg Regional Hospital, Viborg, Denmark. * 7 Department of Research Data and Biostatistics, Aalborg University Hospital, Aalborg, Denmark. * 8 Aarhus University Hospital, Aarhus, Denmark. * 9 Aalborg University Hospital, Aalborg, Denmark. * 10 Kolding Regional Hospital, Kolding, Denmark. * PMID: **42674573** * DOI: [ 10.1302/0301-620X.108B9.BJJ-2026-0517.R1 ](https://doi.org/10.1302/0301-620x.108b9.bjj-2026-0517.r1) Item in Clipboard Randomized Controlled Trial # Locking plate fixation compared with tension-band wiring for patellar fractures: a multicentre randomized controlled trial Peter Larsen et al. Bone Joint J. 2026. Show details Display options Display options Format Abstract PubMed PMID Bone Joint J Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Bone+Joint+J%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Bone+Joint+J%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674573/) . 2026 Sep 1;108-B(9):1182-1189. doi: 10.1302/0301-620X.108B9.BJJ-2026-0517.R1. ### Authors [Peter Larsen](https://pubmed.ncbi.nlm.nih.gov/?term=Larsen+P&cauthor_id=42674573)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-1 "Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-2 "Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark."), [Rikke Thorninger](https://pubmed.ncbi.nlm.nih.gov/?term=Thorninger+R&cauthor_id=42674573)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-3 "Department of Orthopaedic Surgery, Randers Regional Hospital, Randers, Denmark.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-4 "Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark."), [Rasmus Pind Severinsen](https://pubmed.ncbi.nlm.nih.gov/?term=Severinsen+RP&cauthor_id=42674573)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-3 "Department of Orthopaedic Surgery, Randers Regional Hospital, Randers, Denmark."), [Jens-Christian Beuke](https://pubmed.ncbi.nlm.nih.gov/?term=Beuke+JC&cauthor_id=42674573)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-5 "Department of Orthopaedic Surgery, Kolding Hospital, Kolding, Denmark."), [Steffen Skov Jensen](https://pubmed.ncbi.nlm.nih.gov/?term=Jensen+SS&cauthor_id=42674573)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-6 "Department of Orthopaedic Surgery, Viborg Regional Hospital, Viborg, Denmark."), [Morten Kerri Rasmussen](https://pubmed.ncbi.nlm.nih.gov/?term=Rasmussen+MK&cauthor_id=42674573)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-6 "Department of Orthopaedic Surgery, Viborg Regional Hospital, Viborg, Denmark."), [Juozas Petruskevicius](https://pubmed.ncbi.nlm.nih.gov/?term=Petruskevicius+J&cauthor_id=42674573)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-4 "Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark."), [Jeppe Barckman](https://pubmed.ncbi.nlm.nih.gov/?term=Barckman+J&cauthor_id=42674573)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-4 "Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark."), [Niels Henrik Bruun](https://pubmed.ncbi.nlm.nih.gov/?term=Bruun+NH&cauthor_id=42674573)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-7 "Department of Research Data and Biostatistics, Aalborg University Hospital, Aalborg, Denmark."), [Rasmus Elsoe](https://pubmed.ncbi.nlm.nih.gov/?term=Elsoe+R&cauthor_id=42674573)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-1 "Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark."); [Trial Site investigators](https://pubmed.ncbi.nlm.nih.gov/?term=Trial+Site+investigators%5BCorporate+Author%5D); [Jan Duedal Rölfing](https://pubmed.ncbi.nlm.nih.gov/?term=R%C3%B6lfing+JD&cauthor_id=42674573)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-8 "Aarhus University Hospital, Aarhus, Denmark."), [Rasmus Jorgensen](https://pubmed.ncbi.nlm.nih.gov/?term=Jorgensen+R&cauthor_id=42674573)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-9 "Aalborg University Hospital, Aalborg, Denmark."), [Jens Traerup](https://pubmed.ncbi.nlm.nih.gov/?term=Traerup+J&cauthor_id=42674573)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-9 "Aalborg University Hospital, Aalborg, Denmark."), [Anne Mette Kold Stausholm](https://pubmed.ncbi.nlm.nih.gov/?term=Stausholm+AMK&cauthor_id=42674573)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-9 "Aalborg University Hospital, Aalborg, Denmark."), [Luis Ferreira](https://pubmed.ncbi.nlm.nih.gov/?term=Ferreira+L&cauthor_id=42674573)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-9 "Aalborg University Hospital, Aalborg, Denmark."), [Mohammed Adel Al-Bayati](https://pubmed.ncbi.nlm.nih.gov/?term=Al-Bayati+MA&cauthor_id=42674573)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-9 "Aalborg University Hospital, Aalborg, Denmark."), [Mette Rosenstand](https://pubmed.ncbi.nlm.nih.gov/?term=Rosenstand+M&cauthor_id=42674573)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-9 "Aalborg University Hospital, Aalborg, Denmark."), [Rikke Serritslev](https://pubmed.ncbi.nlm.nih.gov/?term=Serritslev+R&cauthor_id=42674573)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42674573/#short-view-affiliation-10 "Kolding Regional Hospital, Kolding, Denmark.") ### Affiliations * 1 Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark. * 2 Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark. * 3 Department of Orthopaedic Surgery, Randers Regional Hospital, Randers, Denmark. * 4 Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark. * 5 Department of Orthopaedic Surgery, Kolding Hospital, Kolding, Denmark. * 6 Department of Orthopaedic Surgery, Viborg Regional Hospital, Viborg, Denmark. * 7 Department of Research Data and Biostatistics, Aalborg University Hospital, Aalborg, Denmark. * 8 Aarhus University Hospital, Aarhus, Denmark. * 9 Aalborg University Hospital, Aalborg, Denmark. * 10 Kolding Regional Hospital, Kolding, Denmark. * PMID: **42674573** * DOI: [ 10.1302/0301-620X.108B9.BJJ-2026-0517.R1 ](https://doi.org/10.1302/0301-620x.108b9.bjj-2026-0517.r1) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Aims:** Patellar fractures are associated with considerable postoperative morbidity, and tension-band wiring has high complication rates and suboptimal outcomes. Locking plate fixation is a recent surgical innovation which confers superior biomechanical stability. However, there is little information about the clinical outcomes of this method of treatment. The aim of this study was to compare locking plate fixation with tension-band wiring in patients requiring surgical treatment for a patellar fracture. **Methods:** In this patient- and assessor-blinded, multicentre randomized trial, 122 adults with a displaced patellar fracture were assigned 1:1 to locking plate fixation or tension-band wiring. The primary outcome was patient-reported knee function measured by the five sub-scales of the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 12 months. Superiority was predefined as a statistically significant difference in at least three KOOS sub-scales exceeding the minimal clinically important difference (pain 10, symptoms 9, activities of daily living 6, sport and recreation 10, quality of life 10). Secondary outcomes included additional clinical and functional outcomes. Analyses were performed according to the intention-to-treat principle. **Results:** A total of 63 patients were assigned to locking plate fixation and 59 to tension-band wiring; 57 (90.5%) and 52 (88.1%), respectively, completed 12-month follow-up. Locking plate fixation resulted in statistically significant and clinically meaningful improvements in three KOOS sub-scales at this time: symptoms (mean difference -10.4 (95% CI -16.4 to -4.4)), sport and recreation (-14.1 (95% CI -24.7 to -3.4)), and quality of life (-10.9 (95% CI -19.0 to -2.7)). Removal of hardware, failure of fixation, and reoperation occurred more frequently a
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