Rectus femoris tendon morphometry and practical landmarks for harvesting: A cadaveric study

To perform a qualitative and quantitative cadaveric analysis of the rectus femoris (RF) tendon to determine its suitability as a standalone autograft for knee ligament reconstruction and to identify consistent anatomical landmarks for safe and reproducible harvest.

Ten fresh-frozen cadaveric specimens (nine female, one male) without lower limb pathology were dissected to isolate the RF tendon. Distances from the patella to key anatomical fusions, tendon length, width and thickness were measured. A 1-cm-wide graft was harvested using a 7-mm tendon harvester along an oblique path through two stab incisions, then folded into double-, triple- and quadruple-strand configurations. Diameters and usable lengths were recorded. All measurements were analysed descriptively.

The RF tendon formed a reproducible superficial layer of the quadriceps tendon (QT) with two consistent fusion zones: a distal confluence at 22.4 ± 3.5 mm and a proximal confluence at 58.5 ± 13.2 mm above the patella, defining a 36.1 ± 13.0 mm segment free of deep attachments. Mean tendon length was 300.8 ± 29.6 mm. The tendon was widest proximally (47.0 ± 13.5 mm at 20 cm) and thickest distally (2.07 ± 0.6 mm at 5 cm). Graft diameters measured 8.75 ± 0.75 mm (double), 9.9 ± 1 mm (triple) and 11.4 ± 0.8 mm (quadruple), with corresponding lengths of 151.2 ± 16.3, 98.5 ± 13.3 and 74.0 ± 7.7 mm, respectively.

This cadaveric study mapped the RF tendon as the superficial layer of the QT and identified two consistent confluence zones that define a harvest corridor. Its dimensions support its use in both primary and revision procedures, including combined intra- and extra-articular reconstructions.

Level V, basic science study.