Bipartite Patella Causing Knee Pain in Young Adults: A Report of 5 Cases

Abstract

We report on 5 patients who underwent arthroscopic excision or open reduction and internal fixation for bipartite patella. All patients presented with refractory anterior knee pain. The diagnosis of bipartite patella was made using radiography, and confirmed with magnetic resonance imaging or computed tomographic arthrography. All 5 patients achieved complete resolution of symptoms after surgery, and remained pain-free after a mean followup period of 13 months.

A bipartite patella caused anterior knee pain in an older adult: a case report

“…Others had surgical events (open reduction, internal rotation). 4 Our patient was older than other cases reported in the studies. They were almost young athlets but ours wasn't.…”

“…2 Open reduction and internal fixation of the accessory fragment is invasive and may be considered overtreatment. 4 In some studies as similar as ours, patients with BP were immobilized for 3 weeks, then patients returned to full sporting activity within 3 months. 5 In another study dedicated that rest and anti-inflammatory medication were used for 2 weeks.…”

Unusual cause of anterior knee pain

“…Failure of fusion of these ossification centres may give rise bipartite, tripartite or multipartite patella. 1 Bipartite or tripartite patella becomes symptomatic in young active individuals following direct trauma, overuse, or strenuous athletic activity.…”

“…In 2% to 13% patients, bipartite patellae are symptomatic and cause anterior knee pain as in present case. 1 Bipartite patella is also known as Haswell lesion, and idiopathic osteonecrosis of the patella.…”

Genetics of patella hypoplasia/agenesis

“…The bipartite patella corresponds to a fragmentation of the bone, whose size can be variable ( Figure 1F). 8 This is due to the absence of fusion between the primary ossification centre at the superior-lateral side and the rest of the patella. Bipartite patella is present in 2% to 6% of the general population, 9 either unilateral (57%) or bilateral (43%).…”