ArticlePediatric radiology2025
Bipartite patella revisited: the not so asymptomatic accessory ossicle.
Article in Pediatric radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe bipartite patella is a controversial variant, with definitions spanning from normal to stigmata related to patellofemoral dysplasia.
objectiveThe 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
methodsA 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.
resultsFrom 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.
conclusionThe 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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