Abstract / Summary
Introduction: The patella and ligamentum patellae together form a complex structure in front of the knee joint to stabilise it. The patella is a dense, thick bone and is covered by a compact lamina, which helps delay putrefaction or decomposition after death. This characteristic feature significantly affects the estimation of sex, age, and racial features. Variations in patellar and ligament dimensions aid knee replacement surgery, implant design, reconstruction procedures, and sex differentiation. Aim: To evaluate the patella and ligamentum patellae morphometry to assess the differences between the sides and genders and to classify the patellar articular facet according to the Koyuncu classification. Materials and Methods: This cross-sectional morphometric study was carried out at the Department of Anatomy, Saveetha Medical College and Hospital (SIMATS), Thandalam, Chennai, Tamil Nadu, India, from June 2025 to November 2025 on 32 human cadavers (16 males and 16 females) comprising 64 patellae in total. The dimensions such as height, width, thickness, central ridge length, medial and lateral articular facets of the patella, and the length, thickness, proximal and distal width of the ligamentum patellae were measured and compared between the sides and genders. Patellar facets were categorised as per Koyuncu’s categories. A p-value <0.05 was considered statistically significant. An Independent t-test or Mann-Whitney U test was used for continuous variables based on normality using the Shapiro-Wilk test, and the Chi-square test was used for categorical variables. Results: A significant side difference was observed with only one bony parameter (length of the medial articular facet), and all other bony parameters showed no significant difference between the sides (p-value >0.05). The length, thickness and distal width of ligamentum parameters differed significantly between the sides (p-value >0.05). Significant side differences were observed for all measured ligamentum patellae parameters (p<0.05), with higher values on the right side. Most patellar and ligamentum patellae parameters showed significantly higher values in males than females. As per Koyuncu’s classification, predominance in Type B (82.81%) morphology was noted, followed by Type C (12.50%) and Type A (4.69%). Conclusion: All the patella and ligamentum patellae dimensions showed significant sexual differentiation with unilateral imbalance in specific dimensions like the medial articular facet and all ligament parameters. The most prevalent Type B patellar articular facets ensure the importance of population-specificity in implant design, anterior cruciate ligament repair (ACL repair or reconstruction), and forensic tools in sexual differentiation.