Pseudopatella Identified in Bilateral Gonarthrosis: A Case Report of Preoperative Recognition and Surgical Considerations in Total Knee Arthroplasty

Pseudopatella is a rare ossification within the quadriceps tendon, often associated with chronic mechanical stress or degenerative knee conditions, such as gonarthrosis. We report the case of a 59-year-old patient with bilateral gonarthrosis who underwent cruciate-retaining total knee arthroplasty (TKA). Intraoperatively, a pseudopatella was identified within the quadriceps tendon. To optimize the function of the extensor mechanism and prevent future complications, the ossified mass was carefully excised. The procedure proceeded with standard implant placement, ensuring proper alignment, stability, and soft tissue balance. Postoperative recovery was uneventful, and at follow-up, the patient achieved 100 degrees of flexion and full extension. This case underscores the importance of recognizing pseudopatella as a potential intraoperative finding during TKA, particularly in patients with advanced degenerative joint disease. Appropriate management can enhance joint biomechanics, reduce the risk of complications, and contribute to favorable functional outcomes.