ArticleArthroscopy, sports medicine, and rehabilitation2025
Significant Variation in Quadriceps Tendon Thickness Is Observed Among Cadaveric Specimens.
Article in Arthroscopy, sports medicine, and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To evaluate variation in quadriceps tendon (QT) morphology in cadaveric specimens, focusing on tendon thickness, and to improve current QT harvesting techniques and graft preparation for anterior cruciate ligament (ACL) reconstruction. Methods: Eight fresh-frozen, skeletally mature, midthigh-to-toe cadaveric legs with no history of knee surgery and at least 65 mm of tendon were utilized. There were 4 males and 4 females. The average donor age was 80.4 years (range, 69-93 years), and the average height was 66.1 inches (range, 59 to 72 inches). The tendon was exposed with an open extensile approach via a longitudinal midline incision. Tendon thickness was measured using calipers at the superior pole of the patella and 65 mm proximal to the insertion. Univariate analysis was used to generate sample means, standard deviations, and 95% confidence intervals (CIs). Results: Tendon thickness at the distal patellar insertion site was a mean (standard deviation [SD]) of 8.7 (1.4) mm. At 65 mm proximal to the patellar insertion site, the mean (SD) thickness of the tendon was 6.5 (1.1) mm. The 95% CIs were 7.7 to 9.7 mm for the distal insertion and 5.8 to 7.2 mm for the proximal tendon. The 2 measurement sites had a mean (SD) difference of 2.2 (0.7) mm (95% CI, 1.6-2.8 mm; Conclusions: Quadriceps tendons had a significant decrease in thickness, measuring distally to proximally. However, the thickness was not uniform, and the variation was high among specimens tested. Clinical Relevance: Anatomic variations in QT thickness may contribute to variable graft diameters in ACL reconstruction, highlighting the importance of accounting for tendon morphology for graft preparation, ACL tunnel position, and size.
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