PROGRESSIVE FRAGMENTATION OF A BIPARTITE PATELLA - A CASE-REPORT

Purpose of the study Progressive dissolution of the supero-lateral fra gment of a bipartite patella is reported. Material and methods The pat ient, a 44 year old professor of gymnastics, was examined for long sta nding anterior knee pain. For many years, his daily activities include d forceful knee flexion exercices. Serial radiographs, between 1986 an d 1990, revealed a progressive fragmentation of the accessory ossifica tion center and accompanying calcific deposits in the lateral patellar retinaculum. Results Surgical excision of the calcific mass and acces sory ossification center relieved the painful symptomatology completel y, allowing the patient full normal function at one year's follow-up. Discussion The pathological findings were compatible with a dystrophic calcinosis associated with detritic synovitis. A pathogenic mechanism is hypothesized for this unusual and progressive course of a common c ondition: Repetitive trauma, in this case forceful knee flexion exerci ses, shear microscopic bony fragments of the poorly vascularized acces sory ossification center. These microscopic fragments act as deposits of an apatite crystal which go on to induce the secondary soft tissue calcifications seen in our patient.