Tensor vastus intermedius: a review of its discovery, morphology and clinical importance

Abstract

Background: This review aims to summarise the relevant literature surrounding the tensor vastus intermedius, a newly discovered muscle, and to discuss its morphology and potential clinical importance. No such review currently exists in the literature. Materials and methods: A comprehensive literature search regarding the tensor vastus intermedius was performed using PubMed and Google Scholar in July 2020. Principles of Evidence-Based Anatomy and the Anatomical Quality Assessment Tool were employed to ensure a high-level review. All relevant papers were included and citation tracking was performed to uncover further publications. Results: The tensor vastus intermedius is found in the anterior compartment of the thigh and has a similar morphology to the other vasti muscles. It has four main variations and a consistent neurovascular supply. The muscle has been implicated in a number of case reports and surgical procedures, which are described in detail in this paper. Conclusions: In the four years since the tensor vastus intermedius was formally described, a significant amount of work has been done to help us understand its structure and function. Further efforts are needed to gain a full picture as to its clinical importance. As such, it is recommended that this muscle should be acknowledged in anatomical education.

Anatomical variation of co-existing bilaminar tensor of the vastus intermedius muscle and new type of sixth head of the quadriceps femoris

“…Anterolateral thigh flaps are widely used for reconstruction skin, fascia and muscle of the neck head and after breast mastectomy. [7] Restoring the strength and function of the QF is a key point of rehabilitation after many surgical procedures such as ACL reconstruction. It should be performed before surgery because it improves the chances of returning to sport.…”

“…[6,27] It is the largest muscle in the body by muscle mass and is traditionally described as consisting of four heads: Rectus femoris (RF); Vastus Medialis (VM); Vastus Lateralis (VL), and Vastus Intermedius (VI). [6,7] They all form a common tendon attaching to the base of the patella. [11] Most studies of the anatomical variability of the QF concern duplication of the VM or VL muscle.…”

Anatomy, Morphology and Function of the Tensor of Vastus Intermedius: A Systematic Review

“…Advancements in ultrasound (US) and magnetic resonance imaging (MRI) enabled us to recognize accessory anatomical structures [ 2 , 7 , 17 , 18 , 19 ]. Τhe appearance of the TVI has been evaluated using such diagnostic imaging techniques with high reliability [ 17 , 18 , 20 , 21 ] and this provides the opportunity to examine the shape and role of this function, if any, in vivo [ 18 , 20 , 22 ].…”

“…Furthermore, the presence of another muscle-tendon unit which potentially has an independent innervation may have implications for the whole quadriceps muscle function, which is currently unknown. While a recent review attempted to summarize mainly the anatomical studies regarding TVI musculature [ 22 ], there have been several new studies on TVI architecture and morphology which have not been taken into consideration [ 11 , 16 , 18 , 20 ] while the risk of bias assessment of the included studies was not as evident. Being a newly identified muscle-tendon entity, the amount of evidence is still scarce even though new evidence on TVI presence as part of the quadriceps muscle group is growing.…”

“…Studies have also highlighted that a detailed description of TVI architecture is still lacking which is probably due to the presence of several variations of TVI [ 11 , 18 ]. Hence, updating the previously presented information and providing detailed examination not only of TVI anatomy but as well as its architecture [ 22 ] and its variants will assist in appreciation of the role of TVI for quadriceps function. Therefore, the aim of this review was to examine whether TVI is identifiable in all limbs, secondly, to examine whether this muscle has a consistent morphology in all individuals, and, finally, to summarize findings regarding the function of the TVI.…”