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

Area of Science:

• Orthopedic Surgery
• Anatomy
• Biomechanical Engineering

Background:

• The quadriceps tendon (QT) is crucial for knee ligament reconstruction, including anterior and posterior cruciate ligament (ACL/PCL) repairs, revisions, and multiligament surgeries.
• Existing anatomical guides for QT harvesting are limited, necessitating further research into optimal graft procurement.
• Understanding QT anatomy is vital for successful surgical outcomes in knee reconstruction.

Purpose of the Study:

• To determine the ideal anatomical site for quadriceps tendon harvesting.
• To investigate the correlation between patellar dimensions and potential graft sizes.
• To provide an evidence-based guide for surgeons performing QT autograft procedures.

Main Methods:

• A descriptive morphometric anatomical study was conducted on 12 cadaveric knees.
• The quadriceps tendon was dissected and divided into five 5-mm longitudinal strips.
• Thickness measurements were taken every 10 mm along the tendon's length, with statistical analysis performed using Pearson correlation and various t-tests.

Main Results:

• Quadriceps tendon thickness varied from 0.7 to 9.78 mm (mean 4.94 mm).
• Central and centromedial strips were significantly thicker (mean ~6.04 mm) than lateral and medial strips.
• A significant positive correlation was found between QT thickness and patellar length (r=0.75, p=0.0048).

Conclusions:

• The central and centromedial regions of the quadriceps tendon are confirmed as the optimal harvesting sites.
• Mean QT thickness decreases with distance from the patellar insertion.
• Findings provide valuable anatomical data for optimizing graft selection and harvesting techniques in knee surgery.