Mapping the quadriceps tendon: an anatomic and morphometric study to guide tendon harvesting

Potage, Damien; Duparc, Fabrice; D’utruy, Amaury; Courage, Olivier; Roussignol, X.

doi:10.1007/s00276-015-1486-8

Cited by 20 publications

(22 citation statements)

References 10 publications

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“…Studies have shown a similar decrease in anterior QT width working proximally 18,33 and narrowing, followed by widening, when examining the width of the posterior aspect of the QT. 22 One study even described a phenomenon similar to the “splay” described here: an “additional thickness corresponding to tendinous expansion” on the posterior aspect of the QT. 22 Although QT thickness was not a focus of this study, our data do show a decreasing depth, or thickness, working proximally from the patella (unpublished data), similar to adult studies.…”

Section: Discussionmentioning

confidence: 72%

Quadriceps Tendon Graft Anatomy in the Skeletally Immature Patient

Shea

Burlile

Richmond

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:The quadriceps tendon (QT) is increasingly considered for primary and revision anterior cruciate ligament reconstruction in skeletally immature patients, as it may be harvested as a purely soft tissue graft with considerable tissue volume. Because of distinct rectus tendon (RT) separation from the QT complex, the potential for RT retraction exists and could lead to QT weakness after QT graft harvest.Purpose:To describe the anatomy of the pediatric QT and clarify decussation of the RT and QT to avoid the risk of delayed RT retraction and QT weakness after QT graft harvest.Study Design:Descriptive epidemiology study.Methods:Nine cadaveric knee specimens (aged 4-11 years) underwent gross dissection. Coronal-plane width and depth of the QT were measured at intervals proximal to the superior pole of the patella at distances of 0.0, 0.5, 1.0, and 1.5 times the length of the patella. The distance was measured from the superior patellar pole to the point of RT separation from the remainder of the deeper/posterior QT.Results:The median patellar length was 28 mm (interquartile range, 26-37 mm). The coronal-plane width of the QT was larger superficially/anteriorly when closest to the patella but wider when measured deeper/posteriorly as the tendon extended proximally. The median distance between the superior pole of the patella and RT separation from the QT was 0.95 times the patellar length. The distance to widening of the deeper/posterior aspect of the QT was 1.14 times the patellar length proximal to the patella.Conclusion:The RT begins a distinct separation from the QT above the superior pole of the patella at a median of 0.95 times the patellar length in skeletally immature specimens. The deeper/posterior aspect of the QT begins to increase in coronal-plane width proximally after a distance of 1.14 times the patellar length above the knee, while the superficial/anterior aspect of the tendon continues to narrow. Awareness of the separation of the RT from the QT, and the coronal-plane width variation aspects of the QT proximally, is important for surgeons utilizing the QT as a graft to avoid inadvertent release of the RT from the rest of the QT complex.

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Section: Discussionmentioning

confidence: 72%

Quadriceps Tendon Graft Anatomy in the Skeletally Immature Patient

Shea

Burlile

Richmond

et al. 2019

Orthopaedic Journal of Sports Medicine

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“…Still, the QT is the least used graft for primary ACL reconstruction, with about 10% of the reconstructions being performed with a quadriceps graft 27, 29. It is expected that the use of this graft will be increasing in the future 30 as data shows good anatomical and biomechanical characteristics to the QT graft 26, 31, 32. Also, studies have shown good clinical results with QT graft compared to patellar tendon graft, still considered gold standard by some authors.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes after ACL reconstruction with free quadriceps tendon autograft versus hamstring tendons autograft. A retrospective study with a minimal follow-up two years

Todor

Nistor

Caterev

2019

Acta Orthopaedica et Traumatologica Turcica

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Objective The aim of this retrospective study was to compare the clinical outcomes of anatomic single bundle ACL reconstruction using either a free quadriceps tendon autograft or a quadrupled hamstring autograft with a minimum follow-up of 24 months. Methods Consecutive patients undergoing ACL reconstruction using either a free quadriceps tendon autograft or hamstring tendon autograft from January 2013 to December 2014 were included. ACL reconstruction was done in all patients due to isolated ACL tears. Patients with associated cartilage lesions > Outerbridge III, meniscal lesions in need of meniscectomy or repair as well as patients with prior knee surgery on the affected or contralateral knee were excluded. The primary outcome evaluation was the side-to-side difference in instrumented Lachman testing. Secondary outcome evaluation consisted in the Lysholm, modified Cincinnati and SF-36 scores. Side-to-side difference in range of motion and thigh diameter was also documented. Results After applying the inclusion/exclusion criteria, a total of 82 patients were identified and 72 (87.8%) presented to the hospital for follow-up. There were 39 patients with quadriceps graft (30.64 ± 8.71, range: 18–53 years) and 33 patients with hamstrings (28.60 ± 6.74, range: 18–46 years). No statistically significant difference between groups was detected with regard to KT-1000 measurements (p = 0.326). No significant difference was found between the mean postoperative Lysholm (p = 0.299), the modified Cincinnati (p = 0.665) and the general SF-36 scores between groups (p = 0.588). Less side-to-side thigh diameter difference was noted in the quadriceps graft group (p = 0.026). Conclusion In conclusion, similar clinical results, in terms of stability and subjective measures, can be obtained after ACL reconstruction both with a free quadriceps and a 4-strand hamstring tendons autograft. Level of evidence Level III, Therapeutic Study.

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“…8 Quadriceps tendon thickness also showed significant correlation with patellar height. 9 This study aimed at the morphometric and comparative analysis of patella in eastern part of India.…”

Section: Introductionmentioning

confidence: 99%

Morphometric Study of Patellar Measurement: An Overview from Eastern Zone of India

Biswas¹,

Sharma²

2019

IJCMR

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Introduction: Morphometric analysis of the patella has been reported to be important in forensic identification, implant design and in some reconstructive procedures of the knee. Longevity and success of knee replacement depends also in proper implant dimensions. The size and shape of articular surface of patella, width, height, thickness and width of medial and lateral facets of patella are the important parameters that can determine the stability of patellofemoral joint and implant design. This study aimed at the morphometric and comparative analysis of patella in eastern part of India. Material and Methods: 89 dry bones were collected from the students and the departmental bone bank. Measurements were taken by using Vernier Callipers. Results: Bony features and abnormalities if any were noted. Classification of patella, based on the dimensions of the articular facets and dimensions of the patella and articular facets were also noted. Conclusion: This type of morphometric study on patella may help in implant designing and forensic measurements

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Mapping the quadriceps tendon: an anatomic and morphometric study to guide tendon harvesting

Abstract: The present anatomical study confirmed that QT should be harvested from the central and centromedial regions. Mean thickness was 7.84 mm at the patellar insertion, 7.37 mm at 20 mm from the insertion, 6.41 at 40 mm, 5.61 at 60 mm and 4.33 at 100 mm.

Cited by 20 publications

References 10 publications

Quadriceps Tendon Graft Anatomy in the Skeletally Immature Patient

Quadriceps Tendon Graft Anatomy in the Skeletally Immature Patient

Clinical outcomes after ACL reconstruction with free quadriceps tendon autograft versus hamstring tendons autograft. A retrospective study with a minimal follow-up two years

Morphometric Study of Patellar Measurement: An Overview from Eastern Zone of India

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