Abstract

The authors present a retrospective study of 14 men with a painful bipartite patella who were evaluated clinically and radiologically. The mean age was 27.7 years (range 19 to 42 years). The etiology was traumatic in 12 cases, microtraumatic in 2 cases. All patients reported pain upon pressure on the superolateral aspect of the patella. According to Saupe's classification, there were 10 type III and 4 type II bipartite patellae. Weight bearing skyline views showed wide separation of the accessory fragment in only one case ; the same radiographic examination performed in the same patients after contrast injection showed cartilaginous discontinuity. At arthroscopy, in 11 patients, cartilage discontinuity was always present at the junction area, and severe chondropathy of the articular surface of the fragment was noted in three cases. The accessory fragment was removed from 10 patellae, a modified lateral retinacular release was performed in 4 cases. Pain was completely eliminated after excision of the fragment in 10 cases. All patients returned to full activity within 10 weeks. After lateral retinacular release, three patients returned to full activity within 21.3 weeks on average and one had a poor result.