Anatomical study of quadriceps tendon for anterior cruciate ligament reconstruction

Abstract

Abstract Background The quadriceps tendon is a promising alternative graft choice for anterior cruciate ligament (ACL) reconstruction. Morphology of the graft directly affects the biomechanical properties. However, a few studies are evaluating the anatomical structures of quadriceps tendon as a graft in Asian population. Objective To define the anatomical structures of quadriceps tendon as a graft for ACL reconstruction. Methods Forty-nine quadriceps tendons were dissected and analyzed. Measurements were also done including length, width, and thickness. Results The maximum length of superficial quadriceps tendon was 63.2 ± 12.5 mm (range 37.6–83.4). The maximum length of tendon at the deepest part was 57.2 ± 11.5 (range 30.9–83.4). The maximum length of quadriceps tendon was located at 61.4% ± 13% (range 31.8–83.6) from medial edge of the patella insertion (approximately 5 mm lateral from the center of quadriceps tendon insertion). The width of quadriceps tendon at patella insertion was 42.4 ± 3.8 mm (range 33.8–50.5). The thickness of quadriceps tendon at its maximum length on patella insertion was 6.9 ± 2.0 mm (range 1.5–9.5). Positive correlation between the height of cadaver and the maximum length of quadriceps tendon was noted. Conclusions The maximum length of quadriceps tendon was located 5 mm lateral from the center of quadriceps tendon insertion. Thus, we recommend marking midline of the quadriceps tendon insertion as a medial border of the harvested graft to get maximum length of the graft. Graft length measurement using superficial anatomy should be cautioned because graft shortening might occur.