The management of the painful bipartite patella: a systematic review.

PURPOSE: This study aimed to identify the most effective method for the treatment of the symptomatic bipartite patella.

METHODS

A systematic review of the literature was completed, and all studies assessing the management of a bipartite patella were included. Owing to the paucity of randomised controlled trials, a narrative review of 22 studies was completed. A range of treatments were assessed: conservative measures, open and arthroscopic fixation or excision and soft tissue release and excision.

RESULTS

All of the methods provided results ranging from good to excellent, with acceptable complication rates.

CONCLUSIONS

This is a poorly answered treatment question. No firm guidance can be given as to the most appropriate method of treating the symptomatic bipartite patella. This study suggests that there are a number of effective treatments with acceptable complication rates and it may be that treatments that conserve the patella are more appropriate for larger fragments.

LEVEL OF EVIDENCE: IV.