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Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Surgical excision of bilateral patella stress fractures in an elite marathon runner
  1. Joshua W Thompson1,2,
  2. Ganan T Radakrishnan1,2,
  3. Babar Kayani1,2 and
  4. Fares Haddad1,2
  1. 1Trauma & Orthopaedics, University College London Hospitals NHS Foundation Trust, London, UK
  2. 2Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK
  1. Correspondence to Joshua W Thompson; joshua.thompson{at}doctors.org.uk

Abstract

Vertical stress fractures of the patella are rare, with only a handful of bilateral cases reported. Stress fractures in the athletic community are often due to repetitive strain and submaximal loading, with minimal recovery time. An Olympic marathon runner in her 30s presented with right anterolateral knee pain. MRI revealed an acutely displaced vertical fracture of the lateral patella. After failure of non-operative treatment, she underwent surgical excision of the fracture fragment and lateral patellofemoral retinacular repair. Despite return to light training pain-free 3 weeks after surgery, she presented 2 months later with a contralateral vertical patella stress fracture. On this occasion, early operative treatment was performed with early return to training and resolution of symptoms.

This is the first reported case of bilateral vertical patellar stress fractures in an athlete treated with excision of the fracture fragment. This is an excellent option for elite athletes who require a quick postoperative recovery, complete resolution of symptoms and early return to preinjury level of sport.

  • Orthopaedics
  • Sports and exercise medicine

http://dx.doi.org/10.1136/bcr-2021-247563

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    Footnotes

    • Contributors JWT wrote and edited the manuscript; GTR wrote and edited the manuscript; BK wrote and edited the manuscript; FH performed surgery, conducted patient follow-up and supervised manuscript synthesis.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.