40-year-old male patient with knee pain and snapping. Evaluate for tendinosis/chondral lesion status post patellar tendon repair. MENISCI: The medial and lateral menisci are intact.ARTICULAR CARTILAGE AND BONE: There is a patella alta deformity as seen on prior radiographs. Evaluation of bone marrow signal intensity in the proximal tibia is limited by metal artifact from an orthopedic screw. Small surgical tunnels are noted within the patella. Otherwise, bone marrow signal is within normal limits.There is moderate to severe degeneration of the articular cartilage of the patella with near-full-thickness to full-thickness cartilage loss inferiorly along the median eminence. There is relatively mild degeneration of the articular cartilage of the femoral trochlea. The tibiofemoral compartment articular cartilage appears relatively preserved.LIGAMENTS: The cruciate and collateral ligament are intact. EXTENSOR MECHANISM: The patellar tendon is thickened with linear increased signal intensity extending longitudinally within its substance and anterior to the patella. These findings likely represent a combination of tendinosis, insertional tearing, and surgical changes. We see no fluid signal intensity traversing the tendon to indicate rupture. The distal quadriceps tendon appears normal. There is a small amount of edema in Hoffa's fat pad superiorly.
Postsurgical changes of patellar tendon repair with tendinosis and interstitial tearing without evidence of rupture. There is a patella alta deformity with moderate to severe degeneration of the articular cartilage of the patella.