Painful Bipartite Patella in Young Athletes The Diagnostic Value of Skyline Views Taken in Squatting Position and the Results of Surgical Excision

Ishikawa, Hitoshi; Sakurai, Atsushi; Hirata, Souichorou; Ohno, Osamu; Kita, Kiyoshi; Sato, Takeru; Kashiwagi, D

doi:10.1097/00003086-199408000-00027

Cited by 45 publications

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“…In cases of acute and sudden pain, often trauma-related, surgery is preferred by some [13,30] and one study suggests it relieves symptoms [13]. For treating larger fragments, or fragments with little mobility, diverse surgical techniques aimed at decreasing traction on the fragment have been developed during the last decade [1,21,22], and in some cases with large lateral fragments, internal fixation has been used [6,14]. Excision of the accessory bipartite fragment has remained the most widely used surgical method of treatment [1,3,21], especially in skeletally mature patients.…”

Section: Introductionmentioning

confidence: 99%

“…Excision of the accessory bipartite fragment has remained the most widely used surgical method of treatment [1,3,21], especially in skeletally mature patients. Elimination of symptoms after excision has been reported in 0.5-to 5-year followups among adolescents [9,14,22,23,30] and adults [13]. One study reports complete pain relief in long-term followup after excision for 13 of 16 skeletally immature adolescents [5].…”

Section: Introductionmentioning

confidence: 99%

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Excision of Painful Bipartite Patella: Good Long-term Outcome in Young Adults

Weckström

Parviainen

Pihlajamäki

2008

Clinical Orthopaedics &Amp; Related Research

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Excision of the accessory bipartite fragment is widely used, but its long-term outcome is not known. We evaluated the outcome after surgical excision of a symptomatic accessory bipartite or multipartite patella fragment in young adult men performing their compulsory military service and determined the incidence of painful bipartite patellae in this group of skeletally mature adults. We followed 25 of 32 patients for a minimum of 10 years (mean, 15 years; range, 10-22 years). The incidence of painful, surgically treated bipartite patella was 9.2 per 100,000 recruits. Patients' median age at surgery was 20 years. There were 19 superolateral and six lateral bipartite fragments. Other radiographic findings were rare. At followup, the Kujala score mean was 95 points (range, 75-100 points), and osteoarthrotic changes (Kellgren-Lawrence Grade 1) were seen in two knees. No reoperations related to bipartite patella occurred during the followup. Symptomatic bipartite patella is rare and does not seem primarily associated with anatomic deviations, but when incapacitating pain persists despite nonoperative treatment, surgical excision seems to yield reasonable functional outcome and quick recovery with no apparent adverse sequelae. Our data suggest there is no reason to avoid this technically undemanding procedure for treating persistent symptoms of bipartite patella in young adults.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Excision of Painful Bipartite Patella: Good Long-term Outcome in Young Adults

Weckström

Parviainen

Pihlajamäki

2008

Clinical Orthopaedics &Amp; Related Research

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“…Symptomatic cases are usually adolescents and young adults with anterior knee pain as the main complaint (Green;Ishikawa et al, 1994;Ogata;Oohashi et al;Weaver). That is why differential diagnosis in anterior knee pain should include BP as well as other reasons.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Bipartite Patella in Turkish Population: Analysis of Bilateral Knee Radiographs in 897 Subjects

et al. 2015

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KOSE, O.; ERASLAN, A.; ERGUN, A.; EGERCI, O. F. & ERCAN, E. C.Prevalence of bipartite patella in Turkish population; analysis of bilateral knee radiographs in 897 subjects. Int. J. Morphol., 33(3):1108-1113, 2015. SUMMARY:Bipartite patella is a normal anatomic variant of patella. There are various data about the prevalence of bipartite patella in the literature. The aim of this study was to investigate its prevalence, type distribution and sex predilection in Turkish population. Bilateral knee radiographs were retrospectively reviewed of 897 consecutive adult patients. Cases with bipartite patella were categorized according to the Oohashi classification. Medical records were examined in order to differentiate symptomatic and asymptomatic bipartite patellae. We contacted symptomatic patients by telephone to learn continuity of knee pain. We identified 11 cases (7 male, 4 female) of bipartite patella among the 283 male and 614 female patients. No bilateral cases were identified. The prevalence of bipartite patella was 1.22% overall, 2.47% in males, and 0.65% in females. The most common type was superolateral bipartite patella as seen in 9 patients (81.8%). One subject had lateral bipartite and one subject had superolateral tripartite patella. Painful bipartite patella was found in only 2 patients (18%). One of them had continuing symptoms even after 12 months. In conclusion, we found that the prevalence of bipartite patella in Turkish population was approximately 1%. Both inclusion of only adult (skeletally mature) subjects and assessment with bilateral imaging increased the reliability of this value. In accordance with the literature, bipartite patella was found significantly more frequent in males and mostly in superolateral type. More studies are needed in order to obtain the prevalence, type and sex distribution of bipartite patella in different populations.

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“…Five studies [3,8,10,11,27] included 52 patients. Halpern and Hewitt [8] were the first to report removal of a type 2 fragment in a 20-year-old female, with 'significant relief' reported after 12 months follow-up.…”

Section: Surgical Excisionmentioning

confidence: 99%

“…Bourne and Bianco [3] performed a case series of 16 patients (12 males and 4 females), with a mean age of 14.5 (11)(12)(13)(14)(15)(16)(17)(18)(19) years. In their detailed follow-up after 84 (12-156) months, they reported an 'excellent' result in 13 of 16 patients.…”

Section: Surgical Excisionmentioning

confidence: 99%

The management of the painful bipartite patella: a systematic review

McMahon

LeRoux

Smith

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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Purpose This study aimed to identify the most effective method for the treatment of the symptomatic bipartite patella. Methods A systematic review of the literature was completed, and all studies assessing the management of a bipartite patella were included. Owing to the paucity of randomised controlled trials, a narrative review of 22 studies was completed. A range of treatments were assessed: conservative measures, open and arthroscopic fixation or excision and soft tissue release and excision. Results All of the methods provided results ranging from good to excellent, with acceptable complication rates. Conclusions This is a poorly answered treatment question. No firm guidance can be given as to the most appropriate method of treating the symptomatic bipartite patella. This study suggests that there are a number of effective treatments with acceptable complication rates and it may be that treatments that conserve the patella are more appropriate for larger fragments. Level of evidence IV.

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Painful Bipartite Patella in Young Athletes The Diagnostic Value of Skyline Views Taken in Squatting Position and the Results of Surgical Excision

Cited by 45 publications

References 0 publications

Excision of Painful Bipartite Patella: Good Long-term Outcome in Young Adults

Excision of Painful Bipartite Patella: Good Long-term Outcome in Young Adults

Prevalence of Bipartite Patella in Turkish Population: Analysis of Bilateral Knee Radiographs in 897 Subjects

The management of the painful bipartite patella: a systematic review

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