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Background <p>The bipartite patella is a controversial variant, with definitions spanning from normal to stigmata related to patellofemoral dysplasia.</p> Objective <p>The purpose of this study is to quantitatively determine if a bipartite patella is in the spectrum of normal versus forme fruste of underlying patellofemoral dysplasia in children using magnetic resonance imaging (MRI) data. A secondary purpose is to assess the MRI findings of the symptomatic bipartite and its implications for patient care.</p> Materials and methods <p>A retrospective review of bipartite patellae imaged on knee MRI from 1/2010–3/2024 was conducted. Matched cohorts of control and patellofemoral dysplasia knees were created. Trochlear depth, sulcus angle, CDI, TT-TG, lateral patellar tilt and subluxation, lateral trochlear inclination, and clinical management were evaluated, comparing the bipartite knee MRIs with control and dysplastic knees. Chi-square and Mann–Whitney <i>U</i> tests were used, with <i>P</i>-values for significance set to 0.05.</p> Results <p>From 46 patients, 47 bipartite patellae (mean age, 13.3 ± 3.1) were included in the study. In total, 77% (36/47) were male (mean age, 13.6 ± 3.0) while 23% (11/47) were female (mean age, 12.2 ± 3.2). No significant difference in quantitative measurements existed between bipartite patellae and control knees. Significant differences existed for all quantitative measurements defining trochlear dysplasia between bipartite and patellofemoral dysplasia cohorts (<i>P</i>&lt;0.001 for all measurements). Bipartite ossicle edema (39/47, 83%) and Hoffa fat pad edema (17/47, 36%) were frequently present. Six of 47(13%) required surgery for pain management- all had ossicle edema present.</p> Conclusion <p>The presence of a bipartite patella does not appear to be associated with underlying patellofemoral dysplasia. The bipartite patella can frequently be a source of a child’s pain and should not be treated as a normal ossification variant.</p>

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Bipartite patella revisited: the not so asymptomatic accessory ossicle

  • 期刊论文

  • 发表日期：

    2025年8月6日

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  • Samuel X. Ramirez,
  • Stuart D. Ferrell,
  • Indranil V. Kushare,
  • J. Herman Kan

摘要

Background

The bipartite patella is a controversial variant, with definitions spanning from normal to stigmata related to patellofemoral dysplasia.

Objective

The purpose of this study is to quantitatively determine if a bipartite patella is in the spectrum of normal versus forme fruste of underlying patellofemoral dysplasia in children using magnetic resonance imaging (MRI) data. A secondary purpose is to assess the MRI findings of the symptomatic bipartite and its implications for patient care.

Materials and methods

A retrospective review of bipartite patellae imaged on knee MRI from 1/2010–3/2024 was conducted. Matched cohorts of control and patellofemoral dysplasia knees were created. Trochlear depth, sulcus angle, CDI, TT-TG, lateral patellar tilt and subluxation, lateral trochlear inclination, and clinical management were evaluated, comparing the bipartite knee MRIs with control and dysplastic knees. Chi-square and Mann–Whitney U tests were used, with P-values for significance set to 0.05.

Results

From 46 patients, 47 bipartite patellae (mean age, 13.3 ± 3.1) were included in the study. In total, 77% (36/47) were male (mean age, 13.6 ± 3.0) while 23% (11/47) were female (mean age, 12.2 ± 3.2). No significant difference in quantitative measurements existed between bipartite patellae and control knees. Significant differences existed for all quantitative measurements defining trochlear dysplasia between bipartite and patellofemoral dysplasia cohorts (P<0.001 for all measurements). Bipartite ossicle edema (39/47, 83%) and Hoffa fat pad edema (17/47, 36%) were frequently present. Six of 47(13%) required surgery for pain management- all had ossicle edema present.

Conclusion

The presence of a bipartite patella does not appear to be associated with underlying patellofemoral dysplasia. The bipartite patella can frequently be a source of a child’s pain and should not be treated as a normal ossification variant.