Patients with a quadriceps tendon shorter than 60mm require a patellar bone plug autograft in anterior cruciate ligament reconstruction.

Abstract

To assess the length and thickness of the quadriceps tendon (QT) and anterior cruciate ligament (ACL) to predict the required QT length for individual ACL reconstruction. Thirty patients (9 females, 21 males; mean age 24.5years; mean height 169.3cm) who underwent ACL reconstruction using the QT with a bone plug autograft were enrolled. The length and thickness of the QT on preoperative magnetic resonance imaging (MRI) were compared with those measured under direct visualization. The ACL length was measured on preoperative MRI and three-dimensional computed tomography after ACL reconstruction. The QT length on MRI was compared with the required graft length, and the factors related to an adequate QT length were assessed. The mean QT length on MRI was 60.8 ± 1.3mm and was significantly positively correlated with the QT length under direct visualization (P < 0.01). On MRI, the mean ACL length was 30.8 ± 1.2mm and the mean QT thickness was 6.3 ± 0.2mm. Although the mean QT was 0.1mm longer than the mean required graft length, the QT on MRI was shorter than the required graft length in 37% of patients (11/30). Adequate QT length was related to a QT length of more than 60mm, but not to age, sex, height, or ACL length. Although preoperative MRI predicted the required QT length for ACL reconstruction, 37% of patients lacked an adequate QT length, and a QT shorter than 60mm required the addition of patellar bone. III.