Ogata technique for bipartite patella. A, Oblique skin incision is made over distal portion of vastus lateralis tendon, extending just distal to midportion of separated area of patella. B, Vastus lateralis tendon is split along its middle fibers, and insertion to painful patellar fragment is detached subperiosteally. Continuity of tendon-periosteum complex to main portion of patella is preserved. C, Fragment is relieved from muscle traction without causing mediolateral imbalance that would affect patellofemoral tracking. Care should be taken not to injure synovial capsule to preserve some blood supply to fragment. SEE TECHNIQUE 45.29.