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International Journal of Surgery Case... Jan 2024A bipartite patella is a rare anatomical variant of the patella. A patella bipartite is often asymptomatic and is often an incidental finding on radiological imaging....
INTRODUCTION
A bipartite patella is a rare anatomical variant of the patella. A patella bipartite is often asymptomatic and is often an incidental finding on radiological imaging. The patella remains bipartite when secondary ossification centers fail to fuse. Herein, a case of bipartite patella improved after knee arthroscopy and surgical removal.
PRESENTATION OF THE CASE
A 57-year-old male with a history of polytrauma. He complained of progressive pain in the right knee area. A radiological investigation reported a right bipartite patella. The condition improved after the open removal of the accessory patella.
DISCUSSION
This case is considered type III according to Saupe's classification. Due to its location and radiological appearance, it is a painful synchondrosis of a bipartite patella.
CONCLUSION
After the failure of conservative management, the removal of the bipartite patella was necessary and unavoidable to restore everyday activities.
PubMed: 38142546
DOI: 10.1016/j.ijscr.2023.109165 -
Knee Surgery, Sports Traumatology,... Apr 2015Bipartite patella has been recognized as an incidental radiographic finding. However, symptomatic bipartite patella is occasionally diagnosed in adolescents and young... (Review)
Review
PURPOSE
Bipartite patella has been recognized as an incidental radiographic finding. However, symptomatic bipartite patella is occasionally diagnosed in adolescents and young athletes. The incidence of bipartite patella has been reported at 0.2-1.7, and 1-2 % of these cases are symptomatic. The purpose of this review article was to discuss current concepts relevant to developmental anomaly of ossification type patella partita.
METHODS
A PubMed database search using the key words "bipartite patella" was performed. Clinical papers reporting the bipartite patella were included. Four German-language studies were also included, three for incidence of bipartite patella and one for classification.
RESULTS
A new classification of developmental anomaly of ossification type patella partita based on location and number of fragment was recently proposed. It is simple and useful and applicable to all types of bipartite or tripartite patella. Several imaging studies have reportedly been used to evaluate symptomatic bipartite patella. MRI is currently the most appropriate method used to assess patients with bipartite patella. Although surgical procedures have been developed that reduce excessive traction force by the vastus lateralis muscle on the bipartite fragment, there is not sufficient evidence to support their use for routine treatment of painful bipartite patella.
CONCLUSION
In most symptomatic cases, movement at the interface between the bipartite fragment and the body of the patella presumably causes the pain. Therefore, the existence of apparent motion at the interface should be confirmed by specific imaging studies before surgery. Magnetic resonance imaging findings may provide such evidence by demonstrating a fluid bright signal across the segmentation, typical of pseudoarthrosis.
LEVEL OF EVIDENCE
V.
Topics: Bone Diseases, Developmental; Humans; Magnetic Resonance Imaging; Osteogenesis; Patella
PubMed: 24531356
DOI: 10.1007/s00167-014-2887-7 -
The Journal of Hand Surgery, European... Jun 2015
Topics: Child; Humans; Male; Osteogenesis; Radiography; Scaphoid Bone; Wrist Joint
PubMed: 23906787
DOI: 10.1177/1753193413500411 -
Oral and Maxillofacial Surgery Clinics... Aug 2022Frontofacial surgery, encompassing the monobloc with or without facial bipartition and the box osteotomy, can treat the frontal bone and midface simultaneously,... (Review)
Review
Frontofacial surgery, encompassing the monobloc with or without facial bipartition and the box osteotomy, can treat the frontal bone and midface simultaneously, providing comprehensive improvement in facial balance. Complex pediatric patients with genetic syndromes and craniosynostosis are most optimized by an interdisciplinary team of surgeons, pediatricians, geneticists, speech pathologists, audiologists, dietitians, pediatric dentists, orthodontists, and psychosocial support staff to manage the myriad of challenges and complications throughout early childhood and beyond. Despite early treatment of the anterior and posterior cranial vault, these patients frequently have resultant frontal and/or midface hypoplasia and orbital abnormalities that are best managed with simultaneous surgical treatment.
Topics: Child; Child, Preschool; Craniosynostoses; Frontal Bone; Humans; Osteogenesis, Distraction; Osteotomy
PubMed: 35786530
DOI: 10.1016/j.coms.2022.03.001 -
The Journal of Hand Surgery Nov 1990A case of bilateral congenital bipartite scaphoid followed from early ossification of the scaphoid to skeletal maturity is presented. Magnetic resonance imaging was...
A case of bilateral congenital bipartite scaphoid followed from early ossification of the scaphoid to skeletal maturity is presented. Magnetic resonance imaging was shown to be helpful in differentiating this condition from traumatic pseudarthrosis of the scaphoid. The history of this rare anomaly is discussed.
Topics: Adolescent; Carpal Bones; Child; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Pseudarthrosis; Radiography
PubMed: 2269775
DOI: 10.1016/0363-5023(90)90005-c -
Radiology Case Reports Mar 2022Bipartite patella is a normal variation in ossification development. This variation is usually asymptomatic but can cause persistent and debilitating anterior knee pain...
Bipartite patella is a normal variation in ossification development. This variation is usually asymptomatic but can cause persistent and debilitating anterior knee pain with an injury. We report the case of a 56-year-old man complaining of persistent anterior left knee pain following trauma. Standard knee radiographs show a bilateral Bipartite Patella appearance, and magnetic resonance imaging shows discrete bony edema of the cancellous bone of the accessory bone and about the synchondrosis explaining the anterior knee pain, associated with a crack in the posterior compartment of the medial meniscus. Conservative care including medical treatment with non-steroidal anti-inflammatory drugs, physical therapy was used. Magnetic resonance imaging is the most valuable diagnostic tool for evaluating detailed morphologic and pathologic changes in patients with the bipartite patella.
PubMed: 35003469
DOI: 10.1016/j.radcr.2021.12.007 -
Seminars in Musculoskeletal Radiology Apr 2023Anatomical variants are frequently encountered when assessing the sacroiliac joints (SIJ) using magnetic resonance imaging. When not located in the weight-bearing part... (Review)
Review
Anatomical variants are frequently encountered when assessing the sacroiliac joints (SIJ) using magnetic resonance imaging. When not located in the weight-bearing part of the SIJ, variants associated with structural and edematous changes can be misinterpreted as sacroiliitis. Their correct identification is necessary to avoid radiologic pitfalls. This article reviews five SIJ variants involved in the dorsal ligamentous space (accessory SIJ, iliosacral complex, semicircular defect, bipartite iliac bony plate, and crescent iliac bony plate) and three SIJ variants involved in the cartilaginous part of the SIJ (posterior dysmorphic SIJ, isolated synostosis, and unfused ossification centers).
Topics: Humans; Sacroiliac Joint; Sacroiliitis; Magnetic Resonance Imaging; Extremities
PubMed: 37011623
DOI: 10.1055/s-0043-1761954 -
The Journal of the American Academy of... Aug 2008Bipartite patella is usually an asymptomatic, incidental finding. However, in adolescents, it may be a cause of anterior knee pain following trauma or a result of... (Review)
Review
Bipartite patella is usually an asymptomatic, incidental finding. However, in adolescents, it may be a cause of anterior knee pain following trauma or a result of overuse or strenuous sports activity. Most patients improve with nonsurgical treatment. Surgery is considered when nonsurgical treatment fails. Excision of the fragment is the most popular surgical option, with good results. However, when the fragment is large and has an articular surface, excision may lead to patellofemoral incongruity. Lateral retinacular release and detachment of the vastus lateralis muscle insertion are other surgical options and are reported to produce good pain relief and union in some patients. These procedures reduce the traction force of the vastus lateralis on the loose fragment. Internal fixation of the separated fragment has limited support in the literature. Understanding the possible consequences of different treatment approaches to painful bipartite patella is necessary to preserve quadriceps muscle strength and patellofemoral joint function.
Topics: Humans; Internal Fixators; Knee Joint; Orthopedic Procedures; Ossification, Heterotopic; Patella; Radiography
PubMed: 18664634
DOI: 10.5435/00124635-200808000-00004 -
Orthopedics Nov 2009
Review
Topics: Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal; Child; Female; Humans; Joint Diseases; Male; Orthopedic Procedures; Osteogenesis; Pain; Patella; Rest; Sports
PubMed: 20422748
DOI: 10.3928/01477447-20090922-20 -
Journal of Pediatric Orthopedics Mar 1982
Topics: Femur; Fetus; Humans; Osteogenesis
PubMed: 7076835
DOI: 10.1097/01241398-198202010-00009