Regional variations in human patellar trabecular architecture and the structure of the proximal patellar tendon enthesis

H. Toumi, I. Higashiyama, D. Suzuki, Tsukasa Kumai, G. Bydder, D. McGonagle, P. Emery, J. Fairclough, M. Benjamin

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Proximal patellar tendinopathy occurs as an overuse injury in sport and is also characteristic of ankylosing spondylitis patients. It particularly affects the posteromedial part of the patellar tendon enthesis, although the reason for this is unclear. We investigated whether there are regional differences in the trabecular architecture of the patella or in the histology of the patellar tendon enthesis that could suggest unequal force transmission from bone to tendon. Trabecular architecture was analysed from X-rays taken with a Faxitron radiography system of the patellae of dissecting room cadavers and in magnetic resonance images of the knees of living volunteers. Structural and fractal analyses were performed on the Faxitron digital images using MatLab software. Regional differences at the enthesis in the thickness of the uncalcified fibrocartilage and the subchondral plate were evaluated histologically in cadaveric material. The radiological studies showed that the quantity of bone and the apparent trabecular thickness in the patella were greatest medially, and that in the lateral part of the patella there were fewer trabeculae which were orientated either antero-posteriorly or superiorly inferiorly. The histological study showed that the uncalcified fibrocartilage was most prominent medially and that the subchondral plate was thinner laterally. Overall, the results indicate that mechanical stress at the proximal patellar tendon enthesis is asymmetrically distributed and greater on the medial than on the lateral side. Thus, we suggest that the functional anatomy of the knee is closely related to regional variations in force transmission, which in turn relates to the posteromedial site of pathology in proximal patellar tendinopathy.

Original languageEnglish
Pages (from-to)47-57
Number of pages11
JournalJournal of Anatomy
Volume208
Issue number1
DOIs
Publication statusPublished - 2006 Jan
Externally publishedYes

Fingerprint

Patellar Ligament
patella (bones)
Patella
tendons
bone
Fibrocartilage
radiography
Tendinopathy
knees
histology
pathology
digital image
sport
anatomy
Knee
bones
Cumulative Trauma Disorders
software
Fractals
Mechanical Stress

Keywords

  • Bone
  • Fibrocartilage
  • Osteotendinous junction
  • Radiography
  • Trabeculae

ASJC Scopus subject areas

  • Agricultural and Biological Sciences (miscellaneous)
  • Anatomy

Cite this

Regional variations in human patellar trabecular architecture and the structure of the proximal patellar tendon enthesis. / Toumi, H.; Higashiyama, I.; Suzuki, D.; Kumai, Tsukasa; Bydder, G.; McGonagle, D.; Emery, P.; Fairclough, J.; Benjamin, M.

In: Journal of Anatomy, Vol. 208, No. 1, 01.2006, p. 47-57.

Research output: Contribution to journalArticle

Toumi, H, Higashiyama, I, Suzuki, D, Kumai, T, Bydder, G, McGonagle, D, Emery, P, Fairclough, J & Benjamin, M 2006, 'Regional variations in human patellar trabecular architecture and the structure of the proximal patellar tendon enthesis', Journal of Anatomy, vol. 208, no. 1, pp. 47-57. https://doi.org/10.1111/j.1469-7580.2006.00501.x
Toumi, H. ; Higashiyama, I. ; Suzuki, D. ; Kumai, Tsukasa ; Bydder, G. ; McGonagle, D. ; Emery, P. ; Fairclough, J. ; Benjamin, M. / Regional variations in human patellar trabecular architecture and the structure of the proximal patellar tendon enthesis. In: Journal of Anatomy. 2006 ; Vol. 208, No. 1. pp. 47-57.
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