bipartite patella

[tmv]

Hi there. Just wondering if anyone has had any experience with a bipartite patella. My son was just diagnosed yesterday after 2 years of intermittant right knee pain. What worked for you? They are suggesting a complete cast from hip to heel for 6 weeks to "settle" it down. Then, surgery to remove the smaller separate bone if this doesn't help the pain. I'd love to hear your stories. Thank you in advance.

[Stevekays]

I had bipartite patella surgery a couple years ago, and realized my surgeon didnt shave down the kneecap where the fragment was removed as he was supposed to from what I now understand. When I asked him about it he said he wasnt sure it would make any difference, but he could try doing it now ! I should explain , I am in Canada,Toronto to be precise, and it seems like hardly any drs here have even heard of this surgery believe it or not . My dr told me he has only done it a couple times before and hes probably near 70 ! Anyhow now I am thinking about finding another dr who will take care of this properly . I would even be willing to travel to the USA to be safe and get it done right . Has anyone here since pics of their xray after surgery and did they really round out the area where the piece was taken out? I am going crazy wondering how much difference it will make,because it sure hurts like heck now, no better than before surgery really.,and I suffered for many years before I finally had surgery .Seeing the xray made me think it definitely shouldnt look like that with those jagged corners on each side though .  

[cstevenmort]

How are you doing?  
Are you better now?

[stein55]

My 16 year old son is two weeks post op today (3/26/13, knee arthroscopy and partial patella excision) and I was frustrated by the lack of post-surgery information, so I thought I would take to this forum to add more information.

I will start with the background. My son, injured his knee in December of 2011, hitting a brick wall with great force during a basketball game...diagnosed with a bone contusion. He got his mobility back fairly quickly, only missing a few weeks of practice (over Christmas break) and did not miss a game, however endured pain when bending beyond a certain point and suffered extreme pain when his knee cap was hit directly.

He continued to play baseball, train for football, played on his high school legion baseball and summer basketball teams and was very active, but never was 100%..still hurt to run and jump, lost speed and vertical. We used a lot of ice and ibuprofen to get him through. Everything I heard was that bone bruises could take quite a while to heal...months to years, but he was beginning to get frustrated.

At his summer physical exam, his pediatrician noticed that when bent, his affected right knee had a huge bump on the outer top portion...almost like a giant bone spur. Off we went to the ortho. Upon initial x-rays, his bipartite patella was diagnosed. Given that he is very active and how his pain manifested when examined, surgery was presented as an option right away. This was not taken lightly. Because of how the bone had calcified post-injury, it was causing malalignment and pulling the entire knee cap to the right when bending.

He was given a choice, however, to do it during the season he wanted to, as he had the opportunity to letter as a sophomore in football and basketball. So he played through the pain. We scheduled surgery right after basketball season on March 12th. Surgery went well, he had his superolateral bipartite fragment removed (top right corner of patella on right knee, little larger in area than a quarter) and a lot of scar tissue from his initial injury removed. Fortunately, no quad tendon repair was necessary as his fragment was not attached to it.

His leg is completely immobilized, mostly for the incision to heal as his was about 3-3.5 inches long. The first couple of days were pretty painful, but he switched from hydrocodone to ibuprofen within 4 days and stopped taking ibuprofen altogether 6 days post op. He started getting around without crutches about 5 days post op, but still with his leg straight and immobilized.

Today we had his two week post op visit. His leg strength is great and incision healed quickly. He can only bend about 30 degrees due mostly to his leg having to be completely straight for two weeks. He starts PT this week and we are going to a sports PT specialist that will push him to progress. Our OS thinks he will have a quick rehab and be ready for another busy summer. I will post an update after a few weeks to update you. You can view his leg here.. this is right after they cut off the bandaging from surgery this morning, before they cleaned his leg up. The sutures were subdermal and the top layers of skin were glued and it will leave a line visible but not the railroad type scarring. He also had the two small, lower incisions from his arthroscopy. https://pbs.twimg.com/media/BGSVzEWCUAAJic j.jpg:large

Read more: Orthopedics Forum - bipartite patella treatment http://ehealthforum.com/health/bipartite-patella-treatment-t147765.html#quick_reply_input#ixzz2OfIQt5o0

[cstevenmort]

How is your son doing?  My son had Bipartite patella surgery 4 months ago.  He can walk fine, bike, but as soon as he tries to run, he gets pain.  Quad is still really week.  
Would love to hear how your son is doing and how long it took for recovery.
Thanks
chad

[sdice]

i am a 38 yo female and have had bipartite patella of both knees since i was 11 or 12.  the doctors at the time told my mother that i would just have to live with it or get surgery if the pain continued.  well i did not have the surgery.  i remember how bad the pain was even now and it did last for a few years, with occasional flare-ups.  my knee caps have a bony prominence.  i dont know which is better, having surgery or living with it. it would be your own presonal preference and severity of pain.  mine was severe and i could not walk up steps for months, but the pain does eventually decrease.

[vinnie17368]

I need help, i am 13 years old and i play travel soccer. i was at a practice and came down on my right knee and booom, my leg started to hurt, from then on i have seen a physical theropist and he said stay off of it, that was the same day i was diagnosed with a bipartite patella. it is on the right side of the right knee if im looking at it sitting down.please comment if you have any advice for me. and please answer me this question, can i continue playing soccer for the rest of my life after this thing is healed or if it can heal.

[lath396]

Im 19, just had surgery about 3 months ago,they took out a piece of my left knee as it was causing pain. i couldnt tense muscle for long time or lift my leg and very sore.as of now im walking and cycling every second day and trying 2 build muscle up.am hoping that pain subsides over time.just cant wait 2 surf and get active again.would reccommend surgery as there is a greater chance of correcting it than leaving it how it is.cheers

[JoBu0305]

Just diagnosed this morning after 3 years of intermittent pain and flare ups in my left knee. Prognosis: Small piece needs to be taken out, but recovery will be months at best. Got a cortisone shot to see if it will buy me some time, would prefer to deal with it in the fall, not summer. A bit disappointing that it took all this time to determine root cause, had to get a CT Scan to see the fragment, and it is exactly where the pain begins and is at its worst when the knee flares up.

[brandnewknee]

It takes a while, man, just keep stretching it and building your muscles up. I thought I'd never walk again! I had the surgery on August 25, and in November I was able to roll around my local skatepark. Probably not smart, and I couldn't do any tricks or anything, but it was possible. By the following summer I was hiking in Yosemite. A solid year until you're as good as new- hang in there!

[brandnewknee]

I am a 34 year old male who has been skateboarding since age 10. Needless to say, my knees have taken a lot of abuse, and on top of the wear and tear I was diagnosed with a bipartite patella almost two years ago. The pain in my left knee was so severe that I could hardly walk uphill or up stairs. I had the surgery to remove the smaller fragment almost a year and a half ago, and I'm better than ever. Skateboarding, snowboarding, jogging, hiking in the Sierra Nevadas... Make sure your son goes to a competent surgeon (of course), and follows through with a competent physical therapist- his leg (literally) will not work after surgery, the muscles get so traumatized that they "forget" how to function. I needed PT to re-learn how to clench my muscles in my leg, but I did the PT, joined a gym, stretched it out (that's the worst part), and I'm back to normal. I would recommend the surgery, and if you're anywhere in New England then go to New England Orthopedic Surgeons, they're the best. Best of luck!

[GRizz560]

how long after the bipartite surgery, w/ 2 screws heal time ????my name is jay and this really sux soo

[sportysoftballchic23]

I am a 17 yr. old athlete with knee pain in both knees. The pain started in only my left knee, but I have recently noticed increased pain in my right knee. I have been to three different doctors and none of them have come to the same conclusion. They all do agree however that I have a bipartite patella in my left knee. They say that I have had it since birth. I was wondering that if you have a bipartite patella in one knee is it likely to have it in the other knee also. If so this would perhaps explain my right knee pain along with my left knee pain. I have not yet been seen for my right knee pain, but all three of the doctors that I have seen say that my bipartite patella should not be causing my pain. They say my pain is related to something else, but none of my doctors can tell me what it is. I really would like to know if my bipartite patella could be causing my pain! I mean something has to be causing my pain and so far that is the only problem that they have found with my knee. I wish to learn more about bipartite patella, so if anyone has any information I would greatly like to hear it. Thank-you

[DAVE911]

I AM CURRENTLY IN THE MILITARY AND HAVE BEEN HAVING KNEE PAIN FOR 3 YEARS.  FOR THE FIRST 2 - 2 1/2 YEARS THE DOCTORS SAID IT WAS ONLY PFPS, AND PLACED ME ON MOTRIN.  I CAN'T COUNT HOW MANY TIMES I WENT IN AND SAID THAT IT HURTS, AND AGAIN IT'S PFPS.  FINALLY IN MID 2007 I HAD A FOLLOW UP WITH A DIFFERENT DOCTOR AND HE TOOK XRAYS FOR THE 6TH TIME, AND SAID YOUR KNEE CAP IS BROKEN.  SO HE SENT ME TO PHISICAL THERAPY FOR 3 MONTHS.  THEY SAID SORRY THERE IS NOTHING WE CAN DO (YOU WERE BORN WITH THIS). BEFORE THE MILITARY I WAS A FULLTIME FIREFIGHTER, AND BEFORE THAT I WORKED AT A COUNTY JAIL.  I NEVER HAD A SINGLE PROBLEM. I AM TOTALLY LOST AND PISSED OFF.  THEY SAID THAT I WILL HAVE TO LIVE WITH IT.