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Standardizing relative location of the patellar tendon insertion on magnetic resonance imaging

摘要


Background: The junction of the patellar tendon (PT) insertion on the tibial tubercle (TT) is an active area during human activity. Physiologically, the PT and its insertion are key elements of the extensor mechanism and considerably affect the kinematics of the lower limbs. Clinically, these structures are also frequently encountered during routine operations around the knee. Despite their importance, the relationships among the PT, its insertion, and other adjacent structures have rarely been explored. Purpose: The purpose of this retrospective study was to determine the relative locations of the PT and TT by using magnetic resonance imaging (MRI). Understanding the exact relative locations of these structures may increase the precision, reliability, and convenience of interventions and evaluations in this area. Methods: MRI data for 100 consecutive young adult patients (50 men and 50 women; average age, 27 years) were studied. All patients underwent MRI for meniscus or ligament injuries of the knee. They did not have knee fractures or bony anomalies. The tibial width (TW), TT apex, PT insertion width, and distance from the articular surface to the TT were measured and compared statistically. Results: The average TW and average PT insertion width were 64 and 23 mm, respectively. A small distance (~0.6 mm) was observed between the TT apex and PT center, with the TT being more medially located. The center of the PT was located 38% from the lateral end of the TW. The male and female patients differed significantly in terms of the TW, PT insertion width, and distance from the articular surface to the TT (all p < 0.001). Conclusion: The TT apex may be regarded as the center of the PT and is located 38% from the lateral end of the TW. A clearer understanding of the relative locations of the aforementioned structures can facilitate more appropriate and precise clinical evaluations and interventions.

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