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Updated: Jan 15, 2026

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Anatomical variability in the quadriceps tendon: structural layering and patellar insertion patterns.

Hyun Jin Park1, Seong-Kyu Choi2, Hongtae Kim2

  • 1Department of Anatomy, School of Medicine, Konkuk University, 268, Chungwon-daero, Chungju-si, Chungcheongbuk-do 27478, Republic of Korea.

The Knee
|October 9, 2025
PubMed
Summary

Quadriceps tendon anatomy varies significantly in elderly Koreans, with four distinct layering types identified. Understanding these variations is key for improving knee surgery outcomes.

Keywords:
Quadriceps tendonRectus femorisVastus intermediusVastus lateralisVastus medialis

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Area of Science:

  • Anatomy
  • Orthopedics
  • Gerontology

Background:

  • The quadriceps tendon is vital for knee stability and extension.
  • Its anatomical variability, especially in elderly populations, is not fully understood.

Purpose of the Study:

  • To investigate anatomical variations in the quadriceps tendon of elderly Korean cadavers.
  • To analyze the structural layering and muscle contributions at the patellar insertion.

Main Methods:

  • Dissection of 63 quadriceps tendon specimens from 35 Korean cadavers.
  • Assessment of the composition and arrangement of rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), and vastus intermedius (VI).

Main Results:

  • Four distinct quadriceps tendon configurations were identified based on muscle layering.
  • Type 1 (40%) showed RF superficial, VM/VL middle, VI deep; Type 2 (40%) had RF merging with VM/VL.
  • Type 3 (15%) lacked VM contribution; Type 4 (5%) comprised only RF and VI. Vastus muscles were often larger than RF and VI.

Conclusions:

  • Significant anatomical variability exists in the quadriceps tendon of elderly Koreans.
  • These findings suggest personalized surgical approaches may enhance knee procedure outcomes.