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1981.60 THE PATELLOFEMORAL JOINT
Robert J Nicoletta, MD
Anthony A Schepsis, MDANATOMY- The patella is the largest sesamoid bone in the body.
Its blood supply arises mainly from the peripatellar
plexus. The patella articulates with the femoral sulcus.
It is asymmetrically oval in shape with the apex distal.
It is enveloped by fibers of the quadriceps tendon and
blends with the patellar tendon distally. The patella
serves as a fulcrum for the quadriceps muscles. The
main biomechanical function of the patella is to
increase the moment arm of the quadriceps mecha-
nism. - The patellar surface is divided into two large
facets—medial and lateral, which are separated by a
central ridge. The facets are covered by the thickest
hyaline cartilage in the body that may measure up to
6.5 mm. The superior three-fourths of patella are
articular and the inferior one-fourth is nonarticular.
The contact area between the patella and femur
varies with knee position. At 10°to 20° of knee
flexion the distal pole of the patella contacts the
femoral trochlea. As flexion increases, the contact
356 SECTION 4 • MUSCULOSKELETAL PROBLEMS IN THE ATHLETE