Edama M, Kageyama I, Nakamura M, Kikumoto T, Nakamura E, Ito W, Takabayashi T, Inai T, Onishi H
Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.
Department of Anatomy, School of Life Dentistry at Niigata, Nippon Dental University, Niigata, Japan.
Scand J Med Sci Sports. 2017 Dec;27(12):1681-1687. doi: 10.1111/sms.12858. Epub 2017 Mar 27.
In this study, detailed investigations into the shape of the inferior patellar pole, the site of the patellar tendon attachment, and the length and course of the patellar tendon were performed with the aim of examining the anatomical factors involved in the developmental mechanism of patellar tendinitis. The investigation examined 100 legs from 50 cadavers. The inferior patellar pole was classified into three types: pointed, intermediate, and blunt. The attachment of the patellar tendon to the inferior patellar pole was classified into two types: an anterior and a posterior. The length of the patellar tendon was measured from the tibial tuberosity to the inferior patellar pole. The pointed type was seen in 57% of legs, the intermediate type in 21%, and the blunt type in 22%. Twenty-one legs were the pointed type, as well as the anterior type. The patellar tendon was significantly shorter with the posterior type than with the anterior type. The blunt type also had a significantly shorter patellar tendon than the pointed type. In legs that were both the pointed type and the anterior type, the inferior patellar pole and the proximal posterior surface of the patellar tendon impinged during knee flexion due to the posterior tilt of the patella, suggesting the possibility that this may induce damage. With the posterior type and blunt type, on the other hand, the possibility of strong tensile stress on the tendon fibers of the posterior facet of the inferior patellar pole was suggested.
在本研究中，对髌下极的形状、髌腱附着部位以及髌腱的长度和走行进行了详细研究，目的是探讨与髌腱炎发生机制相关的解剖学因素。该研究检查了来自50具尸体的100条腿。髌下极分为三种类型：尖型、中间型和钝型。髌腱与髌下极的附着分为两种类型：前侧型和后侧型。髌腱长度从胫骨结节测量至髌下极。尖型在57%的腿中可见，中间型在21%的腿中可见，钝型在22%的腿中可见。21条腿为尖型且为前侧型。后侧型的髌腱明显比前侧型短。钝型的髌腱也明显比尖型短。在既是尖型又是前侧型的腿中，由于髌骨后倾，髌下极和髌腱近端后表面在膝关节屈曲时相互撞击，提示这可能导致损伤。另一方面，后侧型和钝型提示髌下极后侧面的肌腱纤维可能承受强大的拉伸应力。
