The patellar tendon (patellar ligament) runs from the inferior patellar pole to the tibial tuberosity, transmitting quadriceps force to extend the knee. It is a continuation of the quadriceps mechanism and is under the highest tensile load of any tendon in the body during jumping activities, up to 8 times body weight. Despite the name, it functions as a ligament connecting patella to tibia.
| Muscle | |
|---|---|
| Attachment | Inferior pole of the patella to the tibial tuberosity |
Transmits quadriceps force from the patella to the tibia for knee extension
Patellar tendinopathy (jumper's knee) affects the deep posterior fibres of the proximal tendon at the inferior patellar pole, producing activity-related anterior knee pain reproduced by the single-leg decline squat. MRI and ultrasound demonstrate hypoechoic intratendinous signal at the proximal pole. Symptoms are tracked with the VISA-P questionnaire, and management is a progressive tendon loading programme; injections such as PRP and surgical debridement are reserved for tendons that fail several months of loading. Patellar tendon rupture (at the inferior pole or mid-substance) produces loss of active knee extension and a high-riding patella (patella alta). Repair requires suture anchor or transosseous fixation at the patellar pole followed by protective immobilisation.
Inferior patellar pole degenerative overload producing pain during and after jumping, reproduced by decline squat.
Complete tear from sudden quadriceps overload causing inability to extend the knee and a high-riding patella.
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