Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, Connecticut, USA.
Arthroscopy. 2012 Jul;28(7):980-4. doi: 10.1016/j.arthro.2012.01.002. Epub 2012 Apr 11.
The purpose of this study was to review the anatomy of the quadriceps tendon and provide guidelines for harvesting the quadriceps tendon for anterior cruciate ligament (ACL) reconstruction.
Eleven cadaveric knees were dissected, and the quadriceps tendon was analyzed. Multiple measurements of length, depth, and width were taken in a standardized manner for each cadaver and recorded.
The quadriceps tendon superficial morphology showed 2 distinct peaks, with the maximum length correlating with the lateral peak. The mean tendon peak length was 88.3 ± 8.4 mm (range, 78.3 to 99.7 mm). The mean width of the quadriceps tendon at its insertion onto the patella was 43.3 ± 5.8 mm (range, 34.3 to 54.1 mm). The quadriceps tendon was noted to be asymmetric, with the maximum tendon length located at 61.6% ± 4.1% of the width from the medial border of the quadriceps tendon insertion. This point was also the maximum tendon depth at insertion.
Quadriceps free tendon graft harvesting should begin by locating the apex (maximum length) of the quadriceps tendon (61% of the distance from the patella's medial edge). The surgeon should then harvest a 10-mm-wide graft centered about 2 mm medial to this point, using the depth of a No. 10 scalpel blade (7 mm) as a guide to thickness to harvest an optimal quadriceps free tendon graft for ACL reconstruction.
This anatomic study identifies the site of harvest of a quadriceps free tendon autograft (without a patellar bone block) to maximize the length and bulk of the graft for its use in ACL reconstruction.
本研究旨在回顾股四头肌腱的解剖结构，并为前交叉韧带（ACL）重建中股四头肌腱的采集提供指导。
对 11 具尸体膝关节进行解剖，对股四头肌腱进行分析。对每个尸体以标准化方式进行了多次长度、深度和宽度的测量，并记录下来。
股四头肌腱表面形态有 2 个明显的峰，最大长度与外侧峰相对应。肌腱峰值长度的平均值为 88.3±8.4mm（范围，78.3 至 99.7mm）。股四头肌腱在髌骨上的插入处的平均宽度为 43.3±5.8mm（范围，34.3 至 54.1mm）。股四头肌腱不对称，最大肌腱长度位于距股四头肌腱插入部内侧缘 61.6%±4.1%的宽度处。该点也是插入时的最大肌腱深度。
股四头肌腱游离肌腱移植物的采集应首先确定股四头肌腱的顶点（最长长度）（髌骨内侧缘的距离的 61%）。然后，外科医生应在距该点内侧 2mm 处采集 10mm 宽的移植物，以 No.10 手术刀刀片（7mm）的深度为厚度指南，以获取用于 ACL 重建的最佳股四头肌腱游离移植物。
这项解剖研究确定了股四头肌腱游离肌腱移植物（不带髌骨骨块）的采集部位，以最大限度地增加移植物的长度和体积，用于 ACL 重建。
