Successful Treatment of Painful Synchondrosis of Bipartite Patella after Direct Trauma by Operative Fixation: A Series of Six Cases.

Abstract

Introduction:The patella is the largest sesamoid bone in the body and may have one (77%) or multiple (23%) ossification centres. Patellar and patellofemoral joint abnormalities are a common cause of anterior knee pain but symptomatic bipartite patella is an uncommon problem.Case Series:We report a series of six cases of painful synchondrosis in bipartite patellae, all in keen athletes following a direct blow to the anterior aspect of the knee. A complete rupture of the synchondrosis with evidence of retropatellar chondral separation was seen on MRI scan in all cases. Successful surgical fixation was undertaken with complete resolution of symptoms in all patients at an average of three months post-operatively.Conclusion:Painful synchondrosis of a bipartite patella in young and active individuals following direct trauma is a relatively rare cause of anterior knee pain, but may be associated with significant morbidity. In cases refractory to non-operative management, successful symptomatic treatment can be achieved by operative fixation.