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Harvest location has a minimal impact on differences in cross-sectional area of quadriceps tendon in anterior cruciate ligament reconstruction

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  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Anterior cruciate ligament (ACL) reconstruction with quadriceps tendon (QT) has been gaining popularity. However, it is unknown how differences in harvest location of the QT affect its thickness and cross-sectional area (CSA). The present study aimed to clarify the differences in thickness and CSA of the QT based on location of tendon harvesting.

Methods

Patients scheduled for, or who underwent, ACL reconstruction were prospectively included in the study. The short-axis images on ultrasound were used to assess the CSA of the QT at 30 and 60 mm proximal to the superior pole of the patella. QT autografts with CSAs greater than or equal to 10 mm of width were included and measured at three different locations, namely the center, medial one-third, and lateral one-third at the widest diameter of the QT. Patients with less than 10-mm width of the QT at 60 mm proximal to the superior pole of the patella were excluded. The thickness and CSA were compared based on the location of tendon harvest.

Results

Thirty-seven patients were recruited for the study. The mean thickness and CSA were larger in the center of the QT compared to the lateral one-third at 30 mm proximal to the superior pole of the patella (thickness, 6.7 ± 1.3 mm vs. 5.9 ± 1.3 mm; P = 0.009; CSA, 65.6 ± 11.4 mm2 vs. 58.8 ± 11.9 mm2; P = 0.036). There were no significant differences in thickness and CSA of the QT among the three assessment locations at 60 mm proximal to the superior pole of the patella (n.s.).

Conclusion

The thickness and CSA of QT was greater in the center compared to the lateral one-third at 30 mm proximal to the QT insertion point. However, the difference in value was clinically non-significant, and therefore, harvest location of the QT autograft may not meaningfully impact intraoperative graft diameter. As a result, surgeons may choose the harvest location without concern for resultant graft diameter as long as the enough length of QT is secured.

Level of evidence

III.

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Data availability

Raw data that support the findings of this study were generated at the University of Pittsburgh. Derived data supporting the findings of this study are available from the corresponding author on request.

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Funding

No specific funding was obtained for this work.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA

    Jumpei Inoue, Sahil Dadoo, Keishi Takaba, Bryson P. Lesinak, Volker Musahl & Kentaro Onishi

  2. Department of Orthopaedic Surgery, Toyohashi Medical Center, Toyohashi, Japan

    Satoshi Takeuchi

  3. Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA

    Kentaro Onishi

Authors
  1. Jumpei Inoue
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  2. Satoshi Takeuchi
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  3. Sahil Dadoo
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  4. Keishi Takaba
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  6. Volker Musahl
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  7. Kentaro Onishi
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Contributions

JI is the first author. ST, KT, and SD involved in substantial contributions to the data acquisition for the work. KO and BPL involved in revising the work for important intellectual content. VM involved in final approval of the version to be published.

Corresponding author

Correspondence to Kentaro Onishi.

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There is no conflict of interest.

IRB approval

This study was approved by the Institutional Review Board (IRB), i.e., the Ethics Committee of University of Pittsburgh, in Pittsburgh, USA (reference ID no. STUDY19100047).

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Obtained using a written document from all patients.

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Inoue, J., Takeuchi, S., Dadoo, S. et al. Harvest location has a minimal impact on differences in cross-sectional area of quadriceps tendon in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 31, 4791–4797 (2023). https://doi.org/10.1007/s00167-023-07513-w

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