Tripartite Patella: A Rare Case Report.

Abstract

Introduction: Multipartite patella is an incidental diagnosis, rarely symptomatic, and described scantily in the literature. Symptoms are secondary to direct injury or repetitive micro-trauma, resulting in the separation of fibro-cartilaginous joints across the multiple patellar components. Treatment is usually conservative, and occasionally, in resistant cases, surgery is advised.

Case report: We present a 50-year-old with a tripartite patella who presented after a history of falls and incidentally discovered a bipartite patella of the other knee. The symptoms of the tripartite patella were managed conservatively.

Conclusion: Symptomatic multipartite patella should be distinguished from traumatic patella fracture. In old patients, a high index of suspicion is required to differentiate between a traumatic disruption of the multipartite patella with quadriceps avulsion and an avulsion fracture of the patella. Suppose there is a high index of suspicion. In that case, magnetic resonance imaging should be preferred to explain the signs and symptoms by noting bone marrow edema, partial or complete rupture of quadriceps, and quadriceps fat pad edema. We suggest that surgical decisions to either fix the fragment or excise be taken intraoperatively based on size, site, amount of articular surface, and associated tendon avulsion.