The patellar apex is the inferior pointed tip of the patella, providing the origin of the patellar tendon (patellar ligament). It is a stress concentration point where the patellar tendon transitions from its bony attachment to its fibrous substance, and is the site of patellar tendinopathy and jumper's knee.
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| Ossification | The patellar apex is the last part of the patella to ossify, completing by the mid-teens. Sinding-Larsen-Johansson disease involves the secondary ossification centre at the apex. |
The patellar apex is the primary site of patellar tendinopathy (jumper's knee), where degenerative changes occur at the posterior deep fibres of the patellar tendon origin. Ultrasound demonstrates hypoechoic change and neovascularisation at the apex. Inferior pole stress fractures occur in adolescent athletes (patellar apophysitis, Sinding-Larsen-Johansson disease). Patellar apex bursitis can develop from direct kneeling pressure.
Degeneration of the patellar tendon at its origin from the apex in jumping athletes.
Traction apophysitis at the inferior pole of the patella in adolescents.
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