Mapping the quadriceps tendon: an anatomic and morphometric study to guide tendon harvesting.

INTRODUCTION: The quadriceps tendon (QT) may be used in first-line knee ligament surgery (Anterior and Posterior Cruciate Ligaments), surgical revision and multiligament surgery. There are few published anatomic guides to QT harvesting. The present anatomic study sought to determine the ideal harvesting site and exa mined possible correlation between patellar and graft sizes.
MATERIALS AND METHODS: A descriptive morphometric anatomic study was performed on 12 cadaveric knees. The reference anatomical landmark was the center of the superior edge of the patella. The QT was dissected and sliced longitudinally into five 5-mm strips. The central strip corresponded to the anatomic center of the patella. QT thickness was measured every 10 mm over a length of 100 mm. Data were analyzed on Pearson correlation test and Student, Bartlett and Fisher tests (α risk = 0.05).
RESULTS: QT thickness ranged from 0.7 to 9.78 mm, for a mean 4.94 mm. Mean thickness in the lateral, central and medial strips was, respectively, 3.464, 6.040 and 3.899 mm. Central and centromedial strips were thicker than medial, centrolateral and lateral strips; central and centromedial strips were similar at, respectively, 6.040 and 6.041 mm (non-significant: p = 0.95), and significantly thicker than lateral strips. QT thickness showed significant correlation with patellar length (r = 0.75; p = 0.0048; 95% CI [+0.31; +0.93]).
CONCLUSION: The present anatomical study confirmed that QT should be harvested from the central and centromedial regions. Mean thickness was 7.84 mm at the patellar insertion, 7.37 mm at 20 mm from the insertion, 6.41 at 40 mm, 5.61 at 60 mm and 4.33 at 100 mm.