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The patellar tendon is a strong, flat ligament, which originates on the apex of the patella distally and adjoining margins of the patella and the rough depression on its posterior surface; below, it inserts on the tuberosity of the tibia; its superficial fibers are continuous over the front of the patella with those of the tendon of the quadriceps femoris.
The normal knee flexion is between 130 and 150 degrees. Any pain, abnormal movement, or crepitus of the patella should be noted. If there is pain or crepitus during active extension of the knee, while the patella is being compressed against the patellofemoral groove, patellofemoral pain syndrome or chondromalacia patellae should be suspected.
Patellar tendon rupture can usually be diagnosed by physical examination. The most common signs are: tenderness, the tendon's loss of tone, loss of ability to raise the straight leg and observation of the high-riding patella. Radiographically, patella alta can be detected using the Insall and Salvati method when the patella is shorter than its ...
MRI can also show associated bone bruises on the lateral side of the knee, which one study shows, happen in almost half of medial knee injuries. [ 19 ] Knee MRIs should be avoided for knee pain without mechanical symptoms or effusion, and upon non-successful results from a functional rehabilitation program.
The most likely time for the patella to shift laterally is during the first 20–30 degrees of flexion as the quadriceps tighten simultaneously and pull the patella laterally. Beyond 30 degrees, the quadriceps tendon and patellar ligament pull the patella posterior into the groove of the knee joint making lateral dislocation of the patella ...
On a normal radiograph, the line intersects the inferior pole of the patella, and so can be useful in diagnosing a broken femur as well as a patellar tendon rupture. It also helps to define "Schottle point" intra-operatively for reconstruction of MPFL(Medial patello-femoral ligament.) [3] It may also be used to describe the course of an ACL graft.
An angle greater than 25 degrees between the patellar tendon and quadriceps muscle can predispose a person to patellar dislocation. [11] In patella alta, the patella sits higher on the knee than normal. [11] Normal function of the VMO muscle (VMO) stabilizes the patella. Decreased VMO function results in instability of the patella.
This creates normal joint stability. If muscular control does not compensate for ligamentous laxity, joint instability may result. The trait is almost certainly hereditary , and is usually something the affected person would just be aware of, rather than a serious medical condition.