Bipartite patella revisited: the not so asymptomatic accessory ossicle
- 06.08.2025
- Research
Erschienen in:
- Verfasst von
- Samuel X. Ramirez
- Stuart D. Ferrell
- Indranil V. Kushare
- J. Herman Kan
- Erschienen in
- Pediatric Radiology | Ausgabe 10/2025
Abstract
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.
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- Titel
- Bipartite patella revisited: the not so asymptomatic accessory ossicle
- Verfasst von
-
Samuel X. Ramirez
Stuart D. Ferrell
Indranil V. Kushare
J. Herman Kan
- Publikationsdatum
- 06.08.2025
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
Pediatric Radiology / Ausgabe 10/2025
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998 - DOI
- https://doi.org/10.1007/s00247-025-06344-w
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