A rare bilateral anatomical variant of the patellartendon with patellofemoral maltracking: A Case Report

Aim: The cross-double patellar tendon, a rare anatomical variant, is characterized by two distinct tendinous structures that cross between the patella and the tibial tuberosity.This unique feature, observed in the first reported case of bilateral cross-double patellar tendon, is a significant and intriguing discovery.Recognizing this variant is crucial to avoid misdiagnosis as traumatic or postoperative pathology and to understand its potential role in patellofemoral dysfunction.Case Presentation: The 28-year-old man presented with chronic anterior knee pain and a history of childhood patellar instability.MRI of both knees revealed bilateral crossing tendinous bundles with intervening fat planes on T1-weighted sequences, distinguishing this congenital variant from acquired conditions.The potential impact of this variant on the extensor mechanism, patellar maltracking, and progressive cartilage degeneration is a cause for concern.Conclusion: The bilateral cross-double patellar tendon is a rare developmental anatomical variant with distinctive imaging features.Radiologists and orthopedic surgeons must be aware of this entity, as accurate diagnosis is key to preventing misinterpretation as pathology.This responsibility highlights the need for further urgent studies to determine its prevalence, biomechanical implications, and long-term outcomes.