RESEARCH ARTICLE


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



Sarkhell Radha, Michael Shenouda*, Sujith Konan, Jonathon Lavelle, Samuel Church
Department of Trauma & Orthopaedics, Chelsea & Westminster Hospital, London, UK


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© 2017 Radha et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Trauma and Orthopaedics, Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK; Tel: +44 7751 223033, E-mail: m.shenouda@nhs.net


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.

Keywords: Anterior knee pain, Bipartite patella, Synchondrosis rupture, Operative fixation, Patellofemoral joint, Trauma.