PMC5447901_01
Initial radiograph in a patient with anterior knee pain following fall onto left knee, showing bipartite patella with no bony abnormalities.
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F1
Plain radiography in all cases confirmed a bipartite patella with no evidence of obvious other bony pathology (Fig. 1).
Pre-operative MRI images showing bipartite patella with disruption of the synchondrosis and a fissure in the underlying articular cartilage.
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The patients were investigated with MRI scans which revealed a rupture of the synchondrosis and adjacent bone marrow oedema with retropatellar chondral separation (Figs. 2a, b, c).
Intra-operative photograph showing multiple green needles being used to identify the plane of the synchondrosis.
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Multiple green needles were used to identify the plane of the synchondrosis (Fig. 3).
Intra-operative photograph showing the retinaculum overlying the synchondrosis being divided and opened like a book, to allow curettage and decortication.
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The retinaculum overlying the synchondrosis was divided, allowing it to be opened like a book (Fig. 4) and exposing the synchondrosis.
Intra-operative photograph showing operative fixation using two cortical screws.
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Fixation was achieved with fully threaded cortical lag screws (Fig. 5); no bone graft was required.
Post-operative radiographs taken at 6 weeks.
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Clinical and radiological union was achieved at 6 weeks follow-up (Fig. 6).