Bilateral trochlear subchondral insufficieny fracture of the knee in a professional cyclist

This case report presents a rare case of subsequent ipsilateral and contralateral subchondral insufficiency fracture of the knee (SIFK) in the trochlea of the femur within months, manifested in a professional cyclist. SIFKs in the trochlea have not yet been reported in the literature; however, their appearance in a professional cyclist might be explained by the amount of repetitive pressure on the patellofemoral joint when cycling. In both instances, atraumatic anterior knee pain occurred, resolving after conservative treatment for 6-9 weeks. The patient reached their previous activity level. The authors believe SIFK in the younger population may be more common than currently perceived due to its self-limiting behaviour and a lack of performing immediate MRIs in this younger group whenever an overload injury is suspected.