Arthroscopic Bony Resection for Treatment of Symptomatic Bipartite Patella

Ferrari, Márcio B.; Sanchez, Anthony; Sánchez, George; Schantz, Katrina; Gomes, João Luiz Ellera; Provencher, Matthew T.

doi:10.1016/j.eats.2017.03.013

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…Other operative modalities of symptomatic BP include arthroscopic excision, tension band wiring or ORIF [ 7 , 20 ]. In arthroscopic excision, the anteromedial and anterolateral portals provide excellent access to the BP fragment with the knee in full extension [ 21 , 22 ]. Compared to open excision, arthroscopic excision provides faster recovery, fewer complications, less pain, and expedited return of muscle strength, knee effusion resolution, and return to work or sport [ 3 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Bipartite Patella in Adults Treated With Open Excision: Outcomes and Management

Pan

Hennrikus²

2022

Cureus

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IntroductionBipartite patella affects about 2% of people. Most cases are asymptomatic; however, some develop anterior knee pain during a sporting activity or trauma. When conservative treatment fails, surgery can be considered. This study aims to report the outcomes of fragment excision with or without lateral release in adults with the symptomatic bipartite patella. MethodsThe study was approved by the College of Medicine IRB. A retrospective review was performed. Patients were excluded if aged < 18 or had prior knee surgery. Data collected included: age, gender, BMI, sports played, occupation, physical exam findings, Saupe classification, conservative and surgical treatment, advanced imaging used, duration of follow-up, Lysholm score and postoperative complications. ResultsEight patients were studied. The average age was 28.4 years and BMI was 31.5. Sporting activities included hunting, swimming, soccer, golfing and softball. Occupations included office job, laborer, manufacturing plant worker and truck driver. All patients complained of anterior knee pain exacerbated by sports or work. All patients failed >6 months of conservative treatment. Saupe classification included seven types III (superolateral) and one type II (lateral). Surgical treatment included one open excision, six arthroscopicassisted open excisions and one arthroscopic-assisted open excision with the lateral release. The duration of follow-up averaged 15 months. The average preoperative and postoperative Lysholm score was 75 and 93, respectively. One postoperative complication occurred. ConclusionsBipartite patella is an uncommon cause of anterior knee pain in adults. When pain persists despite conservative care, fragment excision of less than 12% of the whole patella with or without lateral release resulted in excellent outcomes in the majority of cases.

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Section: Discussionmentioning

confidence: 99%

Symptomatic Bipartite Patella in Adults Treated With Open Excision: Outcomes and Management

Pan

Hennrikus²

2022

Cureus

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“…Quando o tratamento conservador não é eficaz pondera-se o tratamento cirúrgico. 7 Várias técnicas cirúrgicas foram descritas na literatura, quer por via aberta, quer por via artroscópica. A excisão do fragmento acessório é o procedimento cirúrgico mais comum, associado ou não a procedimentos de partes moles.…”

Section: Discussionunclassified

“…A maioria dos autores considera que o tratamento conservador falha se após seis meses o doente não sente melhoria das queixas álgicas. 7 Na literatura são descritas diversas técnicas cirúrgicas: libertação do músculo vasto lateral, libertação do retináculo lateral, excisão do fragmento doloroso ou fixação do mesmo, podendo ser utilizadas técnicas por via aberta ou artroscópica. 2-4…”

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Patela bipartida – uma apresentação clínica atípica

Quintas¹,

Boavida²,

Monjardino³

et al. 2022

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Bipartite patella is usually an asymptomatic entity. In adults, the incidence is between 0.2% to 6% and only 2% of these is symptomatic. Bipartite patella may cause anterior knee pain, the gold standard treatment is conservative, and the surgical treatment is reserved when the conservative treatment fails. The authors present an atypical clinical presentation of bipartite patella. Because this is a clinical entity that is often underdiagnosed, the subject in question is of paramount importance. The orthopedic community should include this entity in the differential diagnosis of anterior knee pain, and it is important to define guidelines for its diagnosis and treatment.

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“…Bipartite patella is often an incidental, asymptomatic finding on radiographs and can occur bilaterally in up to 43% of cases [3]. Symptoms manifest as knee pain and tenderness that worsen with running, jumping or kicking movements [10]. The etiology of the pain includes the repetitive traction forces of the extensor mechanism of the knee or the patellar maltracking caused by the ‘tight’ lateral retinaculum pulling at the accessory fragment [11].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of surgical treatment of symptomatic bipartite patella in teenage athletes

Pan

Hennrikus

2021

Journal of Pediatric Orthopaedics B

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Bipartite patella affects about 2% of people. Most cases are asymptomatic; however, some develop anterior knee pain during sports. When conservative treatment fails, surgery can be considered. This study reports the outcomes of fragment excision with or without lateral release in teenage athletes with symptomatic bipartite patella. The study was approved by the College of Medicine Institutional Review Board. A retrospective review was performed. Patients were excluded if age >18 or had prior knee surgery. Data collected included age, gender, BMI, sports played, Saupe classification, conservative and surgical treatment, advanced imaging used, duration of follow-up, Lysholm Score and postoperative complications. Five teenage patients were studied. The average age was 15.6 years and BMI was 23. Sports played included basketball, football, track-and-field and soccer. All patients complained of anterior knee pain exacerbated by sports. All patients failed >6 months of conservative treatment. Saupe classification included four type III (superolateral) and one type II (lateral). Two patients had an MRI. Surgical treatment included two open excisions and three arthroscopic-assisted open excisions with lateral releases. The average Lysholm Score was 97. Postoperatively, all patients returned to presurgery sporting activity at an average of 9.8 weeks (range, 6–13 weeks). A 16-year-old male treated by open excision developed a postoperative wound infection. He was successfully treated with irrigation & debridement and antibiotics and returned to sports at 6 weeks. Symptomatic bipartite patella is an uncommon cause of anterior knee pain in adolescent athletes. When pain persists despite conservative care, fragment excision with or without lateral release resulted in excellent pain relief and return to full sporting activity in all cases.

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Arthroscopic Bony Resection for Treatment of Symptomatic Bipartite Patella

Cited by 5 publications

References 10 publications

Symptomatic Bipartite Patella in Adults Treated With Open Excision: Outcomes and Management

Symptomatic Bipartite Patella in Adults Treated With Open Excision: Outcomes and Management

Patela bipartida – uma apresentação clínica atípica

Outcomes of surgical treatment of symptomatic bipartite patella in teenage athletes

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