The posterior patellar surface comprises the articular and non-articular portions. The articular surface is divided by a vertical ridge into medial and lateral facets, with an odd (extreme medial) facet contacting the femur only in deep flexion. The non-articular superior and inferior poles are the sites of quadriceps and patellar tendon attachment respectively.
Chondromalacia patellae involves degeneration of the posterior patellar articular cartilage, most commonly affecting the medial facet and the ridge. Outerbridge classification grades the severity of posterior patellar cartilage damage. MRI demonstrates posterior patellar cartilage signal change and subchondral bone marrow oedema. Patellar resurfacing in total knee arthroplasty replaces the posterior articular surface.
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