Patella Fracture : A Randomized Controlled Trial

Inclusion Criteria: * Male or female patients 65 years of age or older and ambulatory prior to injury (with or without walking aids). * Closed fracture of the patella displaced by 5 mm or greater (Displacement will be determined by measuring the widest displacement on any x-ray view with the knee in full extension). * The patient scores between 3 and 6 on the Clinical Frailty Scale. This score corresponds to a low-demand patient who is ambulatory and functionally independent * Within 14 days of injury, the patient is able to perform a straight leg raise with less than 30 degrees of extensor lag. * Able to read and understand the study consent form document. * Willing and able to sign consent, follow the study protocol and attend follow-up visits. Exclusion Criteria: * Associated extremity injuries or polytrauma injuries that would otherwise require surgery or interfere substantially with rehabilitation or outcome in the opinion of the investigator. * Neurovascular injuries at the level of the knee requiring surgery. * Pathologic fractures. * Periprosthetic fractures, or other knee surgery which would contra-indicate inclusion in the study (e.g. previous patella ORIF or previous surgery involving patella such as patella tendon or quads repair). * Medical contra-indication to surgery. * Likely problems, in the judgment of the investigators, with maintaining follow-up (e.g. patients with no fixed address, intellectually challenged patients without adequate support, etc.).