Tokushukai Medical Group

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Orthopedic Surgery Disease:Pain Splitting Patella

Status which cushion for absorbing impact to knee is broken.

Patella Partita means that the patella (bone at plate) normally one piece is divided into two or more parts, and its cause is unknown. Split patella normally does not have symptom like pain, but when pain occurs on split part, it is called as Pain Split Patella and becomes subject to the treatment.

Cause of pain is a load stress to splitting part.

Due to knee bent stretched in hard sports activities or exercises, pain is induced by inflammation produced by stress burden applied on split part. Many development cases are recognized where quadriceps muscle is strained sports like running or jumping. Pain is developed on split part of patella, many occurs when patella is pressed to upper outside, on knee when it is bent or stretched. Aching pain at front of knee becomes aware of at or after exercise.

Identify split patella by CT.

Patella Partita can be identified by X-ray or CT. Pain Splitting Patella can be diagnosed from the pain is induced when split part is pressed or percussioned.

In case of mild, stretch or icing before or after exercise.

In case of mild and when exercise is continued, stretching of quadriceps femoris muscle (muscle on front of thigh) before exercise, or icing after exercise is performed. In case pain continues, cease sports activity first and make complete local rest to try to ease pain. Conservative treatment like oral anti-inflammatory drugs, external use medicine, or hyperthermia is conducted.

Fig.1 Primary Patella Partita (Saupe classification)
In case pain remains severely even with conservative treatment, surgical treatment is selected. There are three different methods available; one is a method where split parts are treated to try bone adhesion, method which removes split bone fracture (smaller one), and method to treat tendinous tissue to weaken the force pulled by quadriceps muscle.As a preventive method, stretch quadriceps muscle (muscle on front of thigh) before exercise, or icing after exercise is performed.