Radha Sarkhell, Shenouda Michael, Konan Sujith, Lavelle Jonathon, Church Samuel
Department of Trauma & Orthopaedics, Chelsea & Westminster Hospital, London, UK.
Open Orthop J. 2017 May 17;11:390-396. doi: 10.2174/1874325001711010390. eCollection 2017.
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.
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.
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.
髌骨是人体最大的籽骨,可能有一个(77%)或多个(23%)骨化中心。髌股关节异常是前膝痛的常见原因,但有症状的二分髌骨是一个不常见的问题。
我们报告了一系列6例二分髌骨疼痛性软骨结合的病例,所有患者均为活跃的运动员,均遭受了对膝关节前部的直接打击。所有病例的MRI扫描均显示软骨结合完全断裂,并伴有髌后软骨分离的迹象。所有患者均成功进行了手术固定,术后平均三个月症状完全缓解。
年轻活跃个体在直接创伤后出现的二分髌骨疼痛性软骨结合是前膝痛相对罕见的原因,但可能伴有严重的发病率。在非手术治疗无效的病例中,手术固定可成功实现症状性治疗。