Traumatic avulsions of ligament or tendon insertions rarely occur
at the actual interface with bone, which
suggests that this attachment is strong or otherwise protected from
injury by the structure of the insertion
complex. In this study we describe the terminal extent of quadriceps
tendon fibres where they insert into the
patellae of adult rabbits, humans, dogs and sheep. Specimens were examined
by scanning electron
microscopy (SEM) and light microscopy (LM). To facilitate tracing of
tendon fibres the specimens were
decalcified for SEM, and polarised light microscopy (PLM) was used
in the LM segment of the study. By
SEM it was possible to identify mature bone by the presence of
osteocytes and a lamellar organisation.
PLM and SEM showed that, unlike tendon fibres elsewhere, those in
the calcified fibrocartilage were not
crimped. No specific cement line was identified by SEM. Tendon fibres
interdigitated among separate bone
lamellar systems, (osteons or marrow spaces), but did not merge with
the collagen systems of individual
lamellae. The interdigitation was more extensive and the margin
between tendon and bone was less distinct
in the anterior third of the insertion. The segment of calcified
tendon which interdigitated with bone stained
less intensely blue and was less cellular than the more proximal
calcified fibrocartilage zone adjacent to the
tidemark. Lamellar collagen fibres of the bony trabeculae in
the anterior patella were unusually parallel and
longitudinal in orientation, making distinction of interposed
tendon fibres difficult on LM and PLM
sections. LM, SEM and transmission electron microscopy of rabbit
patellae at birth revealed that anterior
quadriceps tendon fibres extended over the patella in a fibrous
cellular layer. By 2 wk of age, this layer had
acquired chondroid features (i.e. cell lacunae and metachromasia)
and contained vessels extending from
patellar marrow. At 6 wk of age, part of this fibrocartilaginous
layer was replaced by mature bone and
osteoid. In the young adult animal, the quadriceps tension interdigitates
extensively with the patellar bone.
This segment of the insertion is perhaps the remnant of calcified
fibrocartilage which has been remodelled by bone formation.