Management of a Meniscus Tear in a Patient With Nail-Patella Syndrome: A Case Report

Nail-patella syndrome is a rare genetic condition that affects multiple organ systems and can lead to small or irregularly shaped patellae. Such irregular patellae can be of particular interest to orthopaedic practice because the small size can commonly lead to patella dislocation. Although the patient was initially evaluated for a medial meniscus tear, his underlying condition of nail-patella syndrome was found with incidental radiographs. The radiographic and MRI findings show hypoplastic patellae bilaterally with no dislocation or subluxation but with a medial meniscus tear. In this case report, we highlight the rarity of nail-patella syndrome, what to look for in the physical exams and diagnostic testing, and the importance of early and accurate diagnosis in order to increase awareness of the condition. While our patient did not present with patella dislocation, it was still crucial to address his underlying diagnosis of nail-patella syndrome. This anatomic variation guides the decision-making for treating concomitant orthopaedic issues such as a medial meniscus tear, as seen in our patient's case. In doing so, awareness of this genetic syndrome can affect future orthopaedic procedures such as knee replacements, and improve patient outcomes overall.