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Patella

life science Maturity 11-13 Next article →

The patella, commonly known as the kneecap, is a vital part of the human skeletal system. It is a flat, rounded, and triangular bone located at the front of the knee joint. Its primary purpose is to protect the anterior articular surface, which is the front part of the joint. In humans, the patella is categorized as a sesamoid bone. A sesamoid bone is a bone that is embedded within a tendon or a muscle. The patella is the largest sesamoid bone found in the human body.

Patella bipartita
Patella bipartita

To understand how the patella works, we must look at its role in knee extension, which is the process of straightening the leg. The patella is attached to the quadriceps femoris muscle via a large tendon. When this muscle contracts, it pulls on the patella to move the lower leg. The bone acts as a lever by increasing the angle at which the quadriceps tendon acts on the femur, or thigh bone. This increased leverage makes the movement much more efficient. To keep the bone in place, the body uses several stabilizers. These include the vastus medialis muscle and the retinacular fibers.

Insall-Salvati ratio of patella baja
Insall-Salvati ratio of patella baja

The physical structure of the patella is quite complex. The apex is the lowest, pointed part of the bone, and it provides an attachment point for the patellar ligament. The top of the bone is attached to the quadriceps femoris tendon. The sides of the bone, known as the medial and lateral borders, connect to different parts of the muscle. The back of the bone is divided into two main sections. The upper three-quarters of this posterior surface articulate with the femur. This area is split into a medial and a lateral facet by a vertical ledge. The lower part of the back surface contains the infrapatellar fat pad, which is filled with fatty tissue.

Patella bipartita
Patella bipartita

Because the patella experiences significant stress during knee movement, its protective coating is very specialized. This coating is called articular cartilage. In an adult, the articular surface is covered by this cartilage to allow for smooth movement. The cartilage can reach its maximum thickness in the center around age 30. This thickness is necessary because of the intense pressure placed on the patellofemoral joint during resisted knee flexion. Flexion is the act of bending the knee. This specialized structure helps the joint withstand the heavy loads placed on it during physical activity.

Human development of the patella begins long before birth. Babies are born with a patella made of soft cartilage rather than hard bone. The process of turning this cartilage into bone is called ossification. This process typically begins when an ossification center develops between the ages of three and six years. The patella actually starts from two separate ossification centers that eventually unite to form one bone. Sometimes, the bone does not fuse perfectly. This can result in a bipartite patella, where the bone is split into two distinct parts. This variation occurs almost exclusively in men.

Patella bipartita
Patella bipartita

Injuries to the patella are common because of its exposed position. A direct impact can cause a fracture, which is a break in the bone. This often leads to swelling and a condition called hemarthrosis, where blood enters the joint. Another common issue is patellar dislocation. This happens when the kneecap slides out of its proper position, usually toward the outside of the leg. This can cause intense pain and swelling. Doctors may use surgery to treat chronic instability. One method is MPFL reconstruction, where a surgeon uses a hamstring tendon to create a new ligament.

Insall-Salvati ratio of patella baja
Insall-Salvati ratio of patella baja

Looking beyond humans, the patella is a feature found in many different types of animals. It is present in many tetrapods, which are four-limbed vertebrates, including cats, dogs, birds, and mice. However, it is not found in whales or most reptiles. Interestingly, scientists discovered in 2017 that some frog species have a cartilaginous structure that may function like a kneecap. This discovery suggests that the patella might have first appeared roughly 350 million years ago. The name itself has a historical connection to language. The word comes from a 17th-century Latin term meaning a shallow dish, describing the bone's shape.

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File:Patella bipartita.jpg
Patella bipartita.jpg
File:Insall-Salvati ratio of patella baja.jpg
Insall-Salvati ratio of patella baja.jpg
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