Morphometric analysis of patella and patellar ligament: a cadaveric study to aid patellar tendon grafts

Ashwini Aithal Padur,Naveen Kumar,Melissa Glenda Lewis,Varalakshmi Chandra Sekaran

doi:10.1007/s00276-021-02837-z

Abstract

PurposeMorphometric analysis of the patella and the patellar ligament is crucial in diagnosing and surgical corrections of knee injuries and patellofemoral joint disorders. Dimensions of the patella and the patellar ligament are frequently used in implant design and ACL reconstruction. This study aims to obtain detailed morphometric data on the patellar ligament and its localization based on gross anatomical dissections in the adult cadavers.MethodsThe present study consisted of 50 lower limbs from formalin-fixed male adult cadavers aged about 70 years (45–85) belonging to the South Indian population. Total length of the quadriceps tendon, patellar height, patellar ligament height, proximal width, distal width and thickness of the patellar ligament were measured meticulously. Mean, standard deviation, median scores of each parameter were computed for groups using SPSS 16.0. Level of significance was considered as p < 0.05. Wilcoxon signed-rank test was used to compare the various parameters on the right and left limbs. The relationships between all parameters were analyzed using Spearman’s rank correlation test.ResultsThere was no statistically significant difference in the various measurements of the patella and patellar ligament between the right and left lower limbs. Patellar ligament length showed positive correlation with ligament thickness (r = 0.36; p = 0.078 for right limb and r = 0.33; p = 0.104 for left limb). Proximal width of ligament showed significant positive correlation with distal width (r = 0.41; p = 0.041 for right limb and r = 0.54; p = 0.006 for left limb).ConclusionThis morphometric data and analysis might be fundamental in understanding various knee conditions in situ and necessary to orthopedic surgeons for successful planning and execution for ACL reconstruction using patellar ligament graft and other patellofemoral joint disorders.Level of evidenceI

Highlights

The most common injury at the knee joint, especially in sportspeople, is a tear of the anterior cruciate ligament (ACL)
Many studies focus on the geometry of patella and patellar tendon, these studies are mainly radiological, intraoperative measurements, and biomechanical studies
The anatomical methods have the disadvantage of limited clinical material for substantial clinical research, the data obtained from these studies are beneficial for adapting to modern surgical procedures

Summary

Introduction

The most common injury at the knee joint, especially in sportspeople, is a tear of the anterior cruciate ligament (ACL). The patella is the largest sesamoid bone in the body that develops within the tendon of the quadriceps femoris muscle and is found on the anterior surface of the femoral condyles. It has two surfaces (anterior and posterior), three borders (superior, medial, and lateral), and an apex pointing inferiorly [31]. The extensor mechanism of the knee consists of the quadriceps muscle group and tendon, the patella, the patellar ligament, the tibial condyles, and the patellar retinaculum [11]. The patellar tendon (patellar ligament) is the central band of the tendon of the quadriceps femoris, which is continued distally from the patella to the

Objectives

Methods

Results

Conclusion