title: Excision of painful bipartite patella: good long-term outcome in young adults.
abstract: Excision of the accessory bipartite fragment is widely used, but its long-term outcome is not known. We evaluated the outcome after surgical excision of a symptomatic accessory bipartite or multipartite patella fragment in young adult men performing their compulsory military service and determined the incidence of painful bipartite patellae in this group of skeletally mature adults. We followed 25 of 32 patients for a minimum of 10 years (mean, 15 years; range, 10-22 years). The incidence of painful, surgically treated bipartite patella was 9.2 per 100,000 recruits. Patients' median age at surgery was 20 years. There were 19 superolateral and six lateral bipartite fragments. Other radiographic findings were rare. At followup, the Kujala score mean was 95 points (range, 75-100 points), and osteoarthrotic changes (Kellgren-Lawrence Grade 1) were seen in two knees. No reoperations related to bipartite patella occurred during the followup. Symptomatic bipartite patella is rare and does not seem primarily associated with anatomic deviations, but when incapacitating pain persists despite nonoperative treatment, surgical excision seems to yield reasonable functional outcome and quick recovery with no apparent adverse sequelae. Our data suggest there is no reason to avoid this technically undemanding procedure for treating persistent symptoms of bipartite patella in young adults.
  
  
  METHODS
  Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Research Department, Centre for Military Medicine, Lahti, Finland. maria.weckstrom@mil.fi
authors.forename: Maria
authors.initials: M
authors.lastname: Weckström
authors.forename: Mickael
authors.initials: M
authors.lastname: Parviainen
authors.forename: Harri K
authors.initials: HK
authors.lastname: Pihlajamäki
mesh_terms: D000293:Adolescent; D000328:Adult; D018771:Arthralgia / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D010147:Pain Measurement; D010329:Patella / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome