Thirteen patients who had fifteen painful bipartite patellae were
managed with a new operative technique in which the vastus lateralis
insertion to the painful patellar fragment is detached subperiosteally
while the continuity of the tendon-periosteum complex to the main portion
of the patella is preserved. A grossly mobile patellar fragment was removed
from five patellae (three type-II and two type-III according to the
classification of Saupe). A fragment that showed minimum mobility was left
in situ in seven type-III and three type-II patellae. All of the patients
had prompt relief of the pain and returned to full sports activity within
two months after the operation. Six of the seven type-III fragments that
had not been removed united by bone to the main portion of the patella
within two years postoperatively, but all three type-II fragments failed to
unite. Over-all, eleven patients (thirteen knees) had an excellent result
at an average of five years postoperatively.