Abstract
IntroductionThe central ridge of the patella is the thickest area of patella and varies among patients. This cadaveric study identified the location and thickness of the bone at the central patella ridge for bone-patellar tendon-bone (BPTB) harvesting.Materials and methodsFifty cadaveric knees were assessed. First, the morphology, length, width, and location of the central patellar ridge were recorded. Then, we transversely cut the patella 25 mm from the lower pole and measured the thickness of the anterior cortex, cancellous bone, and cartilage from both the mid-patella and the central ridge location. Finally, the depth of the remaining cancellous bone at the mid-patella was compared to the bone at the central ridge.ResultsThe location of the central-patellar ridge deviated medially from the mid-patella in 46 samples with an average distance of 4.36 ± 1 mm. Only 4 samples deviated laterally. The mean patella length was 41.19 ± 4.73 mm, and the width was 42.8 ± 5.25 mm. After a transverse cut, the remaining cancellous bone was significantly thicker at the central ridge compared to the bone at the mid-patella.ConclusionsMost of the central patellar ridge deviated medially, approximately 4 mm from the mid-patella. Harvesting the graft from the central ridge would have more remaining bone compared to the mid-patella.
Highlights
Materials and methodsThe morphology, length, width, and location of the central patellar ridge were recorded
The central ridge of the patella is the thickest area of patella and varies among patients
Harvesting the graft from the central ridge would have more remaining bone compared to the mid-patella
Summary
Data collection An institutional review board approval was obtained before initiation of the study. The evaluation and measurement of all specimens were done by 3 separate investigators. Surgical dissection was done to remove the patella from the cadaver. Measurements of the length, width, thickness, distance from medial border of patella to the central ridge, and length of patellar cartilage were obtained. Average distance from the mid-patella to the central ridge was calculated (Fig. 2). After the measurement was done, we transversely cut the patella 25 mm from the lower pole which is the length usually used for BPTB harvesting, and measured the thickness of the anterior cortex, cancellous, cartilage at mid-patella, and central ridge. Using the standard harvesting technique, approximately 10mm thickness of bone was removed, and we compared the depth of the remaining cancellous bone after harvesting the BPTB from the mid-patella with that from the central ridge (Fig. 3). A P value of less than 0.05 was considered to be statistically significant
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