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. 2007;40(8):1716-22.
doi: 10.1016/j.jbiomech.2006.08.009. Epub 2006 Oct 27.

The biomechanical function of the patellar tendon during in-vivo weight-bearing flexion

Louis E Defrate  1 , Kyung Wook Nha, Ramprasad Papannagari, Jeremy M Moses, Thomas J Gill, Guoan Li
Affiliations

The biomechanical function of the patellar tendon during in-vivo weight-bearing flexion

Louis E Defrate et al. J Biomech. 2007.

Abstract

Few studies have investigated the function of the patellar tendon in-vivo. This study quantified the three-dimensional (3D) kinematics of the patellar tendon during weight-bearing flexion. Eleven subjects were imaged using magnetic resonance (MR). Sagittal plane images were outlined to create a 3D model of the patella, tibia, and femur and included the attachment sites of the patellar tendon. Each attachment site was divided into central, medial, and lateral thirds. Next, the subjects were imaged using fluoroscopy from two orthogonal directions while performing a single-leg lunge. The models and fluoroscopic images were used to reproduce the motion of the patella, tibia, and femur. The apparent elongation, sagittal plane angle, and coronal plane angle of each third of the patellar tendon were measured from the relative motion of the attachment sites. All three portions of the patellar tendon deformed similarly with flexion. The length of the patellar tendon significantly from full extension to 30 degrees . From 30 degrees -110 degrees , no significant change in the length of the patellar tendon was observed. The patellar tendon was oriented anteriorly at flexion angles less than 60 degrees and posteriorly thereafter. From full extension to 60 degrees , the medial orientation of the patellar tendon decreased significantly with flexion. These data may have important implications for anterior cruciate ligament reconstruction using patellar tendon autografts and for the design of rehabilitation regimens for patients of patellar tendon repair.

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Figures

Figure 1
Figure 1
The patellar tendon deformed in three dimensions during weight-bearing knee flexion, as demonstrated for one subject. The deformations of the medial, central, and lateral thirds of the patellar tendon were quantified.
Figure 2
Figure 2
The sagittal plane angle was defined as the angle formed between the long axis of the tibia and the projection of the patellar tendon on the sagittal plane of the tibia. The coronal plane angle was defined as the angle between the long axis of the tibia and the projection of the patellar tendon on the coronal plane of the tibia.
Figure 3
Figure 3
The length of the medial, central, and lateral portions of the patellar tendon increased significantly (p < 0.05) from full extension to 30° of flexion. Thereafter, no statistically significant differences in the length of the patellar tendon were observed. (* p < 0.05)
Figure 4
Figure 4
The sagittal plane angle of the medial, central, and lateral portions of the patellar tendon decreased significantly (p < 0.05) from full extension to 110°. At low flexion angles, the patellar tendon was oriented anteriorly, and at high flexion angles, the patellar tendon was oriented posteriorly. (* p < 0.05)
Figure 5
Figure 5
The coronal plane angle of the medial, central, and lateral portions of the patellar tendon decreased significantly (p < 0.05) from full extension to 60°. Thereafter, no statistically significant differences in the coronal plane angle of the patellar tendon were observed. At low flexion angles, the patellar tendon was oriented medially (* p < 0.05)
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