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Knee Surg Sports Traumatol Arthrosc (2015) 23:10711076 DOI 10.1007/s00167-014-2887-7
KNEE
Developmental anomaly of ossication type patella partita
Yoshikazu Oohashi
Received: 5 October 2012 / Accepted: 30 January 2014 / Published online: 15 February 2014 Springer-Verlag Berlin Heidelberg 2014
AbstractPurpose Bipartite patella has been recognized as an incidental radiographic nding. However, symptomatic bipartite patella is occasionally diagnosed in adolescents and young athletes. The incidence of bipartite patella has been reported at 0.21.7, and 12 % of these cases are symptomatic. The purpose of this review article was to discuss current concepts relevant to developmental anomaly of ossication 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 classication.
Results A new classication of developmental anomaly of ossication 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 sufcient 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
conrmed by specic imaging studies before surgery. Magnetic resonance imaging ndings may provide such evidence by demonstrating a uid bright signal across the segmentation, typical of pseudoarthrosis.
Level of evidence V.
Keywords Patella partita Bipartite patella
Developmental anomaly of ossication type Current
concepts Review
Introduction
The patella initially ossies at 35 years of age. As the patellar ossication centre enlarges, expanding margins may be irregular and associated with accessory ossication centres, which are most commonly found superolaterally [24]. Approximately half of them coalesce during childhood and adolescence [28]. In the remaining individuals, this superolateral accessory ossication centre may fail to unite with the main portion of...