![]() ![]() The superior portion of the ring is located anterior to the quadriceps tendon and the inferior portion is posterior to the patellar tendon. The patella receives its blood supply from an anastomotic ring that originates from the geniculate arteries (the supreme geniculate from the superficial femoral artery, four geniculate arteries arising from the popliteal artery, and the recurrent anterior tibial artery arising from the anterior tibial artery). The odd facet ( arrows) is located at the peripheral aspect of the medial facet, and is devoid of cartilage A longitudinal ridge divides the cartilaginous surface into medial and lateral facets. The distal pole is entirely devoid of articular cartilage. The proximal part is termed the basis, and the distal part, the apex. An overview of conservative and surgical management is also presented.ĭrawing showing, from top to bottom, the anterior, posterior, and axial views of the patella. This pictorial essay reviews the relevant anatomy and normal biomechanics of the patella, as well as different mechanisms of injury and types of fractures. Because of the crucial role of the patella in maximizing knee extension, treatment directed toward anatomical restoration is preferred and has been shown to result in improved outcomes. However, awareness of the different morphologic types and mechanisms of injury is important for subsequent management. Complications include stiffness, extension weakness, and patellofemoral osteoarthritis.ĭiagnosis on conventional radiography is usually easy. Fractures may be caused either by excessive force through the extensor mechanism or by a direct blow. Patellar fractures are the most common cause of disruption of the extensor mechanism, six times as frequent as soft tissue injuries such as quadriceps or patellar tendon rupture. They are most prevalent in individuals between 20 and 50 years of age, and they occur twice as often in men as in women. Patellar fractures account for approximately 1% of all skeletal fractures and may result from direct, indirect, or combined injuries. ![]()
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