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The patellar tendon is the distal portion of the common
tendon A tendon or sinew is a tough, high-tensile-strength band of dense fibrous connective tissue that connects muscle to bone. It is able to transmit the mechanical forces of muscle contraction to the skeletal system without sacrificing its ability ...
of the
quadriceps femoris The quadriceps femoris muscle (, also called the quadriceps extensor, quadriceps or quads) is a large muscle group that includes the four prevailing muscles on the front of the thigh. It is the sole extensor muscle of the knee, forming a large ...
, which is continued from the
patella The patella, also known as the kneecap, is a flat, rounded triangular bone which articulates with the femur (thigh bone) and covers and protects the anterior articular surface of the knee joint. The patella is found in many tetrapods, such as m ...
to the
tibial tuberosity The tuberosity of the tibia or tibial tuberosity or tibial tubercle is an elevation on the proximal, anterior aspect of the tibia, just below where the anterior surfaces of the lateral and medial tibial condyles end. Structure The tuberosity o ...
. It is also sometimes called the patellar ligament as it forms a bone to bone connection when the patella is fully ossified.


Structure

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 The tuberosity of the tibia or tibial tuberosity or tibial tubercle is an elevation on the proximal, anterior aspect of the tibia, just below where the anterior surfaces of the lateral and medial tibial condyles end. Structure The tuberosity o ...
; its superficial fibers are continuous over the front of the patella with those of the tendon of the
quadriceps femoris The quadriceps femoris muscle (, also called the quadriceps extensor, quadriceps or quads) is a large muscle group that includes the four prevailing muscles on the front of the thigh. It is the sole extensor muscle of the knee, forming a large ...
. It is about 4.5 cm long in adults (range from 3 to 6 cm). The medial and lateral portions of the
quadriceps tendon In human anatomy, the quadriceps tendon works with the quadriceps muscle to extend the leg. All four parts of the quadriceps muscle attach to the shin via the patella (knee cap), where the quadriceps tendon becomes the patellar ligament. It attach ...
pass down on either side of the patella to be inserted into the upper extremity of the tibia on either side of the tuberosity; these portions merge into the capsule, as stated above, forming the medial and lateral patellar retinacula. The posterior surface of the patellar tendon is separated from the
synovial membrane The synovial membrane (also known as the synovial stratum, synovium or stratum synoviale) is a specialized connective tissue that lines the inner surface of capsules of synovial joints and tendon sheath. It makes direct contact with the fibrous ...
of the
joint A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw ...
by a large infrapatellar pad of fat, and from the tibia by a
bursa ( grc-gre, Προῦσα, Proûsa, Latin: Prusa, ota, بورسه, Arabic:بورصة) is a city in northwestern Turkey and the administrative center of Bursa Province. The fourth-most populous city in Turkey and second-most populous in the ...
.


Clinical significance

The patellar tendon can be injured in a
patellar tendon rupture Patellar tendon rupture is a tear of the tendon that connects the knee cap (patella) to the tibia. Often there is sudden onset of pain and walking is difficult. In a complete rupture, the ability to extend that knee is decreased. A pop may be felt ...
. Because tendon does not regenerate fully in humans, there is a significant clinical need for research into therapies for patellar tendon rupture. It can be used as a tissue source in the repair of other ligaments. In the event of a torn
anterior cruciate ligament The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments (the other being the posterior cruciate ligament) in the human knee. The two ligaments are also called "cruciform" ligaments, as they are arranged in a crossed formation ...
, the patellar tendon can be used in the rehabilitation process. In this case, the middle one third of the patellar tendon is harvested and inserted through tunnels that are drilled into the
femur The femur (; ), or thigh bone, is the proximal bone of the hindlimb in tetrapod vertebrates. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with ...
and
tibia The tibia (; ), also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates (the other being the fibula, behind and to the outside of the tibia); it connects ...
. The portion of the patellar tendon is then drawn through these tunnels in the bone and will be affixed to the bone via screws. The recovery process takes approximately 4–6 months upon the completion of surgery. This patellar tendon method of reconstruction was traditionally the gold standard graft for anterior cruciate ligament reconstruction and is still one of the more preferred methods.http://www.aaos.org/news/aaosnow/apr12/cover1.asp The insertion of the patellar tendon on the tibia is the location of
Osgood–Schlatter disease Osgood–Schlatter disease (OSD) is inflammation of the patellar ligament at the tibial tuberosity (apophysitis). It is characterized by a painful bump just below the knee that is worse with activity and better with rest. Episodes of pain typica ...
.


See also

*
Patellar reflex The patellar reflex, also called the knee reflex or knee-jerk, is a stretch reflex which tests the L2, L3, and L4 segments of the spinal cord. Mechanism Striking of the patellar tendon with a reflex hammer just below the patella stretches the mus ...
* Patellar tendinitis


Additional images

File:Gray350.png, Sagittal section of right knee-joint. File:Gray351.png, Capsule of right knee-joint (distended). Lateral aspect. File:Slide2ast.JPG, PATELLAR TENDON. Deep dissection. Anterior view.


References


External links

* - "Muscles of the anterior (extensor) compartment of the leg." * () {{Authority control Knee ligaments