Knee Stress Fractures

Understanding Knee Stress Fractures: Causes, Symptoms, and Treatment

Knee stress fractures, particularly of the patella, are uncommon occurrences, affecting only about two out of 10,000 athletes. These fractures typically manifest with activity-related pain, progressing to a fatigue stress fracture following minor trauma. In cases where the patella has been previously weakened, as after patella resurfacing surgery, they are termed insufficiency stress fractures.

Causes of Knee Stress Fractures

Several factors contribute to knee stress fractures, including:

  • Repetitive, rhythmic forces applied to the knee.
  • Fatigue or insufficiency.
  • Muscular weakness leading to disturbances in bone remodeling.

Signs and Symptoms

The primary symptom of a knee stress fracture is worsening anterior knee pain, often accompanied by a popping sound if the fracture displaces acutely.


Radiographs (X-rays) may initially appear normal. However, to confirm the diagnosis, your doctor may recommend a bone scan or MRI.


Treatment strategies depend on the extent and nature of the fracture:

  • Activity Modification: Incomplete fractures may only require modification of activities, with immediate cessation of stress-inducing activities.
  • Rest and Support: Mild cases may necessitate the use of crutches and modification of activities until symptoms subside.
  • Immobilization: Complete fractures may require immobilization until healing occurs.
  • Surgical Intervention: Displaced fractures may require operative reduction and internal fixation to restore natural biomechanics.

Additional Recommendations

  • Activity Modification: Modify activities to alleviate symptoms and prevent exacerbation.
  • Rest and Support: Use crutches as needed and ensure complete rest for larger fracture areas.
  • Rehabilitation: Prolonged rehabilitation will be necessary for full recovery, focusing on strengthening and restoring knee function.

By understanding the causes, symptoms, and treatment options for knee stress fractures, individuals can actively participate in their recovery process and facilitate optimal healing.

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