Bipartite Patella in Children Saint Louis MO

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Robert A Shively, MD
(314) 652-4100
915 N Grand Ave
Saint Louis, MO
Business
Washington University Orthopedics
Specialties
Orthopedics

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Leesa Mora Galatz, MD
(314) 747-4573
Ste 11300 West Pavilion
Saint Louis, MO
Specialties
Orthopedics
Gender
Female
Education
Medical School: George Washington Univ Sch Of Med & Hlth Sci, Washington Dc 20037
Graduation Year: 1993

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Angela Kathleen Freehill, MD
660 S Euclid Ave
Saint Louis, MO
Specialties
Orthopedics
Gender
Female
Education
Medical School: Washington Univ Sch Of Med, St Louis Mo 63110
Graduation Year: 1998

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Stephane Leduc, MD
(514) 338-2222
W 185 Kingshighway Blvd Apt 10R
Saint Louis, MO
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Orthopedics
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Male
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Graduation Year: 2007

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Richard H Gelberman
(314) 747-2500
4921 Parkview Pl
Saint Louis, MO
Specialty
Hand Surgery

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Gerard Mark Benecki, MD
(314) 577-8850
3635 Vista at Grand
Saint Louis, MO
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Orthopedics
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Male
Education
Medical School: Univ Of Pittsburgh Sch Of Med, Pittsburgh Pa 15261
Graduation Year: 1998

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Robert Edward Burdge, MD
(314) 577-8850
PO Box 15250
Saint Louis, MO
Specialties
Orthopedics
Gender
Male
Education
Medical School: St Louis Univ Sch Of Med, St Louis Mo 63104
Graduation Year: 1966

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Ken Yamaguchi, MD
(314) 747-2534
One Barnes Hospital Plaza Ste 11300 West Pavilion
Saint Louis, MO
Specialties
Orthopedics
Gender
Male
Education
Medical School: George Washington Univ Sch Of Med & Hlth Sci, Washington Dc 20037
Graduation Year: 1989

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James E Toledano Jr, MD
(314) 577-8850
3635 Vista Ave
Saint Louis, MO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Georgetown Univ Sch Of Med, Washington Dc 20007
Graduation Year: 1993

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Keith Happ Bridwell, MD
(314) 747-2533
Ste 11300 W Pavilion Box 8233 One Barnes Jewish Ho
Saint Louis, MO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Washington Univ Sch Of Med, St Louis Mo 63110
Graduation Year: 1977

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Bipartite Patella in Children

A Patient's Guide to Bipartite Patella in Children

Introduction

Bipartite patella is a congenital condition (present at birth) that occurs when the patella (kneecap) is made of two bones instead of a single bone. Normally, the two bones would fuse together as the child grows. But in bipartite patella, they remain as two separate bones. About one per cent of the population has this condition. Boys are affected much more often than girls.

This guide will help you understand

what parts of the knee are involved how this condition develops how doctors diagnose this condition what treatment options are available Anatomy

What is the patella and what does it do?


The knee is the meeting place of two important bones in the leg, the femur (the thighbone) and the tibia (the shinbone). The patella (kneecap) is the moveable bone that sits in front of the knee. This unique bone is wrapped inside a tendon that connects the large muscles on the front of the thigh, the quadriceps muscles, to the lower leg bone.

Related Document: A Patient's Guide to Knee Anatomy

Causes

What causes this condition?

The patella starts out as a piece of fibrous cartilage. It turns into bone or ossifies as part of the growth process. Each bone has an ossification center. This is the first area of the structure to start changing into bone.

Most bones (including the patella) only have one primary ossification center. But in some cases, a second ossification center is present. Normally, these two centers of bone will fuse together during late childhood or early adolescence. If they don’t ossify together, then the two pieces of bone remain connected by fibrous or cartilage tissue. This connective tissue is called a synchondrosis .


The most common location of the second bone is the supero-lateral (upper outer) corner of the patella. But the problem can occur at the bottom of the patella or along the side of the kneecap.

Injury or direct trauma to the synchondrosis can cause a separation of this weak union leading to inflammation. Repetitive microtrauma can have the same effect. The cartilage has a limited ability to repair itself. The increased mobility between the main bone and the second ossification center further weakens the synchondrosis resulting in painful symptoms.

Symptoms

What does bipartite patella feel like?

Most of the time, there are no symptoms. Sometimes there is a bony bump or place where the bone sticks out more on one side than the other. If inflammation of the fibrous tissue between the two bones occurs, then painful symptoms develop directly over the kneecap. The pain is usually described as dull aching.There may be some swelling.

Movement of the knee can be painful, especially when bending the joint. Atrophy of the quadriceps and malalignment of the patella can lead to patellar tracking problems. Squatting, stair climbing, weight training, and strenuous activity aggravate the knee causing increased symptoms....

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