The morphology of the attachment of the patellar tendon, its bundle orienta
tion, the differential fascicles length and the position of the apex of the
patella were assessed in 22 cadaveric human knees. The patellar apex was 3
9+/-6% of the width of the tendon from its medial edge. The bulk of tendon
was attached to the distal two-thirds of the anterior aspect of the patella
. In six cases tendon fibres originated from the posterior surface of the a
pex of the patella, forming a ridge on the back of tendon. This may represe
nt an anatomical variant accounting for the increased tendon thickness note
d on MRI, both incidentally and during assessment for patellar tendonitis,
Fascicles were parallel in the sagittal plane but converged in the frontal
plane toward their tibial attachment. When bone-patellar tendon-bone (B-PT-
B) grafts were harvested, as for anterior cruciate ligament reconstruction,
the grafts narrowed distally. When harvesting B-PT-B, the oblique orientat
ion of the fibres in the coronal plane must be borne in mind.