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Patellar tendon
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The patellar tendon, also known as the patellar ligament, is a thick fibrous band that extends between the patella and the tibial tuberosity. It is the distal continuation of the quadriceps tendon, indirectly anchoring the quadriceps femoris muscle to the tibia.
The patellar tendon contributes to maintaining patellar alignment and plays a crucial role in transmitting the force generated by the quadriceps, facilitating knee extension and enabling essential movements such as walking, running and jumping.
This article will explore the anatomy, terminology and clinical significance of the patellar tendon.
| Terminology |
English: Patellar ligament Synonyms: Patellar tendon, infrapatellar portion of quadriceps tendon Latin: Ligamentum patellae Synonyms: Tendo patellae |
| Attachments |
Proximal: Apex of patella Distal: Tibial tuberosity |
| Function | Transmits force generated by the quadriceps femoris muscle to the tibia, enabling knee extension. |
Anatomy
The patellar tendon is roughly 6-8cm in length and extends from the apex of the patella and adjacent margins to the tibial tuberosity. The superficial fibers of the patellar tendon merge proximally with the quadriceps femoris tendon over the patella.
In the anatomical position, the patellar tendon is relaxed, however it is tightened by the contraction of the quadriceps femoris during knee extension. It connects with the lateral and medial patellar retinacula laterally, which contribute to the knee joint capsule surrounding the patella. The infrapatellar fat pad separates the patellar ligament from the synovial membrane of the knee joint, whilst the deep infrapatellar bursa separates it from the proximal tibia.
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Tendon or ligament?
The patellar tendon is sometimes referred to as the patellar ligament, a discrepancy that arises from its anatomical attachments. Tendons typically connect muscle to bone, while ligaments link bone to bone. The term patellar tendon is appropriate as it is a continuation of the quadriceps femoris tendon.
At the same time, as it connects the patella to the tibial tuberosity, it is also commonly referred to as the patellar ligament. However, while ligaments primarily function to restrict excessive movement, the patellar tendon’s main role is force transmission, therefore the term patellar tendon could be considered more functionally accurate.
Want to test your knowledge of the patella anatomy? Quiz questions are your secret to success.
Test your knowledge on the knee joint with this quiz.
Clinical aspects
Osgood-Schlatter Disease: This condition is a type of apophysitis, meaning inflammation of a growth plate, caused by excessive tension from the patellar tendon on the tibial tuberosity. It typically affects active adolescents whose tibia has not yet fully ossified, leading to pain and swelling at the site of tendon attachment.
Patellar tendinopathy: Patellar tendinopathy, commonly known as jumper’s knee, is an overuse injury that results from repeated strain on the patellar tendon, leading to microscopic tendon damage and localized pain. This condition is particularly prevalent among athletes in high-impact sports such as basketball, volleyball and track events, where frequent jumping and rapid quadriceps femoris contractions place excessive stress on the tendon. Patients typically experience pain at the apex of the patella, which worsens with activity.
Patellar tendon rupture: Patellar tendon ruptures can be classified as either partial or complete. The tendon typically ruptures proximally, near its attachment to the patella. A complete rupture results in a high-riding patella (patella alta) and requires surgical repair, while a partial tear may lead to tendinopathy and can often be managed with conservative treatment.
Patellar reflex: The patellar reflex is a stretch reflex that occurs when the patellar tendon is tapped while the lower limb is relaxed. This brief stretch of the tendon triggers a signal to the spinal cord, which then sends motor signals to contract the quadriceps femoris (agonist muscle) and inhibit the hamstrings (antagonist muscle). The response is a slight extension of the knee. Brisk reflexes may indicate an upper motor neuron lesion, whereas an absent reflex could suggest a lower motor neuron lesion.
ACL reconstruction using a patellar tendon graft: In cases of anterior cruciate ligament (ACL) rupture, a segment of the patellar tendon can be used as a graft for reconstruction. The harvested tendon is threaded through the tibia and femur, following the natural trajectory of the ACL, extending from just anterior to the intercondylar eminence of the tibia to the posteromedial surface of the lateral femoral condyle.
Patellar tendon: want to learn more about it?
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