Outcomes of surgical treatment of symptomatic bipartite patella in teenage athletes

Pan, Tommy; Hennrikus, William L.

doi:10.1097/bpb.0000000000000855

Cited by 3 publications

(2 citation statements)

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“…Distinctive advantages of arthroscopic intervention are minimal access, no damage to the extensor mechanism, assessing the knee for concurrent pathology, extensile denervation for pain relief, quick recovery, and early return to sport. Studies have shown, excision of the accessory fragment resulted in 100% success in returning patients to prior activities, with 91% returning to their respective sports without symptoms and 9% returning with residual symptoms [ 3 , 10 ]. Being an elite player, we offered arthroscopic surgery to our patient.…”

Section: Discussionmentioning

confidence: 99%

Bipartite Patella in an Elite Football Player – A Rare Cause of Anterior Knee Pain

Gopalakrishnan,

Anbarasan,

Ayyadurai

et al. 2023

JOCR

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Introduction: Bipartite patella is usually an asymptomatic anatomical variant estimated to have a prevalence of 0.2–6% in an adult population. Case Report: A 28-year-old league-level football player presented with the left anterior knee pain of 6 months duration. Imaging studies revealed bilateral bipartite patella. Arthroscopic excision of the fragment was performed following which he returned to play 6 weeks after accelerated sports-specific rehabilitation. Atraumatic knee pain should raise suspicion of the bipartite patella. Surgical intervention plays a key role in patients with refractory pain after careful exclusion of other causes of anterior knee pain. Conclusion: Arthroscopic excision is preferred in the case of a high-demand athlete to accelerate recovery and fasten the return to sport duration. Keywords: Patellofemoral pain, overuse injury, return to sports, arthroscopic surgery.

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Section: Discussionmentioning

confidence: 99%

Bipartite Patella in an Elite Football Player – A Rare Cause of Anterior Knee Pain

Gopalakrishnan,

Anbarasan,

Ayyadurai

et al. 2023

JOCR

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“…When conservative treatment fails, surgery can then be considered [ 9 ]. Few studies have reported on the outcomes of operative treatment in the adult population [ 5 , 10 , 11 ].…”

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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Rapid-acting pain relief in knee osteoarthritis: autologous-cultured adipose-derived mesenchymal stem cells outperform stromal vascular fraction: a systematic review and meta-analysis

Lee,

Lim,

Lee

2024

Stem Cell Res Ther

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Background Knee osteoarthritis (OA) is a leading cause of disability, with current treatment options often falling short of providing satisfactory outcomes. Autologous-cultured adipose-derived mesenchymal stem cells (ADMSCs) and stromal vascular fractions (SVFs) have emerged as potential regenerative therapies. Methods A comprehensive search was conducted among multiple databases for studies up to June 2023. The risk of bias was assessed in randomized and non-randomized studies, adhering to PRISMA guidelines. The study has been registered with PROSPERO (CRD 42023433160). Results Our analysis encompassed 31 studies involving 1,406 patients, of which, 19 studies with 958 patients were included in a meta-analysis, examining both SVF and autologous-cultured ADMSC methods. Significant pain reduction was observed with autologous-cultured ADMSCs starting at 3 months (MD = −2.43, 95% CI, −3.99, −0.86), whereas significant pain mitigation in response to SVF therapy was found to start at 12 months (MD = −2.13, 95% CI, −3.06, −1.21). Both autologous-cultured ADMSCs and SVF provided significant improvement in knee function starting at 12 months (MD = −9.19, 95% CI, −12.48, −5.90 vs. MD = −9.09, 95% CI, −12.67, −5.51, respectively). We found no evidence of severe adverse events linked directly to ADMSC therapy. Conclusion Autologous-cultured ADMSCs offer a promising alternative for more rapid pain relief in knee OA, with both ADMSCs and SVF demonstrating substantial long-term benefits in joint function and cartilage regeneration, in the absence of any severe ADMSC-related adverse events. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-024-04034-2.

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Outcomes of surgical treatment of symptomatic bipartite patella in teenage athletes

Cited by 3 publications

References 23 publications

Bipartite Patella in an Elite Football Player – A Rare Cause of Anterior Knee Pain

Bipartite Patella in an Elite Football Player – A Rare Cause of Anterior Knee Pain

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

Rapid-acting pain relief in knee osteoarthritis: autologous-cultured adipose-derived mesenchymal stem cells outperform stromal vascular fraction: a systematic review and meta-analysis

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