Purpose: Free quadriceps tendon autograft (QTA) has gained popularity for both primary and revision ACL reconstruction. The aim of this study is to measure the dimensions of quadriceps tendon and determine its correlation with patient's height, weight and BMI. This is to provide a guide for patients and surgeons in predicting the suitability of QTA for ACL reconstructions.
Methods: A cross-sectional study in which the length and thickness of the quadriceps tendon was measured in 51 Caucasian patients who underwent primary total knee arthroplasty. Exclusion criteria include non-Caucasians and previous tendon pathology. Patients were selected from routine elective total knee arthroplasty list. Tendon length is taken from musculotendinous junction to its insertion. Thickness was measured at midpoint and at distal insertion. Patients' height, weight and BMI were recorded. The correlation between patient physical parameters and tendon dimensions were determined.
Results: Subjects' median age was 65 years (range 44-87), with 34 females and 17 males. Median length of the tendon was 9 mm (range 70-110), and median insertional thickness was 9 mm (7-10 mm). Median thickness at midpoint was 7 mm (range 4-10 mm). There was moderately positive correlation between subjects' height and tendon length (correlation coefficient 0.50), and also between weight and tendon length (correlation coefficient 0.47). There was no significant correlation between subjects' BMI and the tendon length. There was also no significant correlation between tendon thickness and subject's physical parameters.
Conclusion: This study has shown that most patients could provide adequate QTA for ACL reconstruction. It also points to the fact that no investigation is required to predict the adequacy of QTA. Though further studies with larger sample size are required to confirm this, clinician can rely on analysing patients' physical parameter in predicting the adequacy of QTA for ACL reconstruction.
Level Of Evidence: II.
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http://dx.doi.org/10.1007/s00167-019-05640-x | DOI Listing |
Orthop J Sports Med
January 2025
Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, Arizona, USA.
Background: It has been demonstrated that an athlete's psychological readiness contributes to one's ability to successfully return to sport (RTS) after anterior cruciate ligament (ACL) reconstruction. However, the effect of graft choice on psychological readiness is not yet understood.
Purpose/hypothesis: The purpose of this study was to evaluate the association between graft choice and an athlete's psychological readiness to RTS.
Background: Quadriceps dysfunction is ubiquitous after anterior cruciate ligament (ACL) reconstruction (ACLR). Addressing quadriceps dysfunction is crucial to improve function, reduce the reinjury risk, and maintain long-term knee health. While deficits specific to the quadriceps are well documented, less is known about the effect of an ACL injury on other lower extremity muscle groups.
View Article and Find Full Text PDFJ Perioper Pract
January 2025
San Juan Veterans Affairs Medical Center, San Juan, Puerto Rico.
Case: An active healthy 68-year-old male sustained a bilateral quadriceps tendon rupture while running. He underwent a simultaneous bilateral quadriceps tendon repair in a dual-surgeon approach. The right quadriceps tendon was repaired with a tourniquet, while the left quadriceps tendon tear was repaired without one.
View Article and Find Full Text PDFTrauma Case Rep
February 2025
Department of Orthopaedic Surgery and Sports Medicine, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY 14203, United States of America.
Introduction: Revision quadriceps tendon repair is a challenging problem. In this four-case series, novel quadriceps tendon revision resulted in improved range of motion and durable repair for patients with recurrent rupture.
Methods: Our technique includes a combination of a running locked #5 FiberWire or 2 mm SutureTape suture placed through parallel medial, lateral, and central drill holes in the patella with running Krackow-type quadriceps tendon repair medially and laterally resulting in four strands, delivering the vastus medialis and medial quadriceps tendon to an anatomic repair at the superior pole of the patella, with 2 sutures passed centrally and 1 each passed medially and laterally and then tied.
Cureus
December 2024
Department of Health Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JPN.
Purpose The infrapatellar fat pad (IFP) has the lowest pain threshold among all knee joint components and causes anterior knee pain after knee arthroplasty. It has been reported that selective muscle atrophy of the vastus medialis (VM) and fibrosis of the IFP may develop following knee joint surgery. Ultrasound enables visualization of IFP deformation (A1) from within the joint to the proximal area in response to muscle contraction, and this may be helpful in developing preventive and therapeutic strategies for IFP fibrosis.
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