Painful bipartite patella. A new approach to operative treatment.

Thirteen patients who had fifteen painful bipartite patellae were managed with a new operative technique in which the vastus lateralis insertion to the painful patellar fragment is detached subperiosteally while the continuity of the tendon-periosteum complex to the main portion of the patella is preserved. A grossly mobile patellar fragment was removed from five patellae (three type-II and two type-III according to the classification of Saupe). A fragment that showed minimum mobility was left in situ in seven type-III and three type-II patellae. All of the patients had prompt relief of the pain and returned to full sports activity within two months after the operation. Six of the seven type-III fragments that had not been removed united by bone to the main portion of the patella within two years postoperatively, but all three type-II fragments failed to unite. Over-all, eleven patients (thirteen knees) had an excellent result at an average of five years postoperatively.