Patella
Patella | |
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Details | |
Pronunciation | /pəˈtɛlə/ |
Origins | present at the joint of femur and tibia fibula |
Identifiers | |
Latin | patella |
MeSH | D010329 |
TA98 | A02.5.05.001 |
TA2 | 1390 |
FMA | 24485 |
Anatomical terms of bone |
The patella (pl.: patellae or patellas), also known as the kneecap, is a flat, rounded triangular
.In humans, the patella is the largest
Structure
The patella is a
The front and back surfaces are joined by a thin margin and towards centre by a thicker margin.
The upper third of the front of the patella is coarse, flattened, and rough, and serves for the attachment of the tendon of the quadriceps and often has
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Human left patella from the front
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Human left patella from behind
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Flexion and extension of knee
The upper three-quarters of the patella articulates with the femur and is subdivided into a medial and a lateral facet by a vertical ledge which varies in shape.
In the adult the articular surface is about 12 cm2 (1.9 sq in) and covered by cartilage, which can reach a maximal thickness of 6 mm (0.24 in) in the centre at about 30 years of age. Owing to the great stress on the patellofemoral joint during resisted knee flexion, the articular cartilage of the patella is among the thickest in the human body.
The lower part of the posterior surface has vascular canaliculi filled and is filled by fatty tissue, the infrapatellar fat pad.
Variation
Emarginations (i.e. patella emarginata, a "missing piece") are common laterally on the proximal edge.[1] Bipartite patellas are the result of an ossification of a second cartilaginous layer at the location of an emargination. Previously, bipartite patellas were explained as the failure of several ossification centres to fuse, but this idea has been rejected.[citation needed] Partite patellas occur almost exclusively in men. Tripartite and even multipartite patellas occur.
The upper three-quarters of the patella articulates with the femur and is subdivided into a medial and a lateral facet by a vertical ledge which varies in shape. Four main types of articular surface can be distinguished:
- Most commonly the medial articular surface is smaller than the lateral.
- Sometimes both articular surfaces are virtually equal in size.
- Occasionally, the medial surface is hypoplasticor
- the central ledge is only indicated.
Development
In the patella an ossification centre develops at the age of 3–6 years.[1] The patella originates from two centres of ossification which unite when fully formed.[citation needed]
Function
The primary functional role of the patella is knee extension. The patella increases the leverage that the quadriceps tendon can exert on the femur by increasing the angle at which it acts.
The patella is attached to the
Clinical significance
Dislocation
Patellar dislocations occur with significant regularity, particularly in young female athletes.[2] It involves the patella sliding out of its position on the knee, most often laterally, and may be associated with extremely intense pain and swelling.[3] The patella can be tracked back into the groove with an extension of the knee, and therefore sometimes returns into the proper position on its own.[3]
Vertical alignment
A patella alta is a high-riding (superiorly aligned) patella. An attenuated patella alta is an unusually small patella that develops out of and above the joint.
A patella baja is a low-riding patella. A long-standing patella baja may result in extensor dysfunction.[5]
The Insall-Salvati ratio helps to indicate patella baja on lateral
Fracture
The kneecap is prone to injury because of its particularly exposed location, and fractures of the patella commonly occur as a consequence of direct trauma onto the knee. These fractures usually cause swelling and pain in the region, bleeding into the joint (hemarthrosis), and an inability to extend the knee. Patella fractures are usually treated with surgery, unless the damage is minimal and the extensor mechanism is intact.[7]
Exostosis
An exostosis is the formation of new bone onto a bone, as a result of excess calcium formation. This can be the cause of chronic pain when formed on the patella.
In animals
The patella is found in
Etymology
The word patella originated in the late 17th century from the diminutive form of Latin patina or patena or paten, meaning shallow dish.[12][13]
See also
References
- ^ ISBN 3-13-533305-1.
- PMID 18310694.
- ^ S2CID 208269986.
- ISBN 978-953-51-0995-2. (CC-BY-3.0)
- ^ Yuranga Weerakkody and Frank Gaillard. "Patella baja". Radiopaedia. Retrieved 2018-01-16.
- ^ a b Douglas Dennis (2017-02-25). "TKA in Patella Baja (Infera)". Orthobullets. Retrieved 2019-02-08.
- ISBN 978-3642347450.
- ^ Herzmark MH (1938). "The Evolution of the Knee Joint" (PDF). J Bone Joint Surg Am. 20 (1): 77–84. Archived from the original (PDF) on 2008-12-17. Retrieved 2007-11-17.
- ISBN 0-03-910284-X.
- ^ "Frogs have hidden, ancient kneecaps". New Scientist. Jul 15, 2017.
- PMID 28667673.
- ^ New Shorter Oxford
- ^ "patella - Origin and meaning of patella by Online Etymology Dictionary". www.etymonline.com.