A Rare Case of Complete Sequestration of the Patella: an Unusual Presentation of Patellar Tuberculosis

Abstract

Osteoarticular tuberculosis affecting the knee with isolated involvement of the patella is rare, accounting for less than 0.09% to 0.15% of cases. We present a case of 48-year-old man presenting with chronic knee swelling, pain, and stiffness. Radiographs revealed a completely sclerotic patella with erosions and irregular margins. Magnetic resonance imaging revealed chronic synovitis, joint effusion, and bony erosions with full-thickness cartilage defects in the patella. He underwent surgical debridement with extensive synovectomy, and a total patellectomy was performed. Intraoperative samples conclusively diagnosed it as a tubercular infection of the patella and synovium. The patient was started on antitubercular chemotherapy. A 2-year follow-up revealed good knee function with an extensor lag of 100. There has been no recurrence of infection. This report is a rare case of complete patellar sequestration secondary to tuberculosis patella, which was successfully treated with radical debridement and patellectomy.