Surgical excision of bilateral patella stress fractures in an elite marathon runner

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.