Presentation
Chronic knee pain.
Patient Data
The patellar tendon displays double bands: a well-formed superficial band inserted at the tibial tuberosity and another deep band that turns medially along the upper tibial head with broadened insertion showing peritendinous edema and subcutaneous fluid signals. Both bands preserve their signals with no significant change.
Other findings include mild osteoarthritis manifested by patellar spurs, fine marginal osteophytes, denuded articular cartilages, and subchondral cystic changes. There are minor ACL degenerative intrasubstance signals.
Medial patellar articular surfaces display chondromalacia grade III, along with a small Baker cyst and mild knee joint effusion.
The posterior horn of the medial meniscus shows a type II signal.
Case Discussion
The patellar tendon anomalies are extremely rare. In the current study, an example of the crossed doubled patellar tendon is clarified in an old man with osteoarthritis, chondromalacia patellae, and degenerative changes of the menisci and ACL.
The influence of a doubled patellar tendon on patella tendinopathy and internal derangement, as a result of altered mechanics, is currently unknown and requires further investigation.
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