2023 ISAKOS Biennial Congress ePoster
Morphological Evaluation Of The Quadriceps Tendon Using Preoperative Ultrasound In Anterior Cruciate Ligament Reconstruction
Satoshi Takeuchi, MD, PhD, Toyohashi JAPAN
Kevin J Byrne, MD, Pittsburgh UNITED STATES
Ryo Kanto, MD, Nishinomiya, Hyogo JAPAN
Kentaro Onishi, DO, Pittsburgh, pa UNITED STATES
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, UNITED STATES
FDA Status Not Applicable
Summary
Preoperative ultrasound revealed the length of the quadriceps tendon was less than 70 mm in 48.6% of patients (17/35), which was considered to be inappropriate length to be harvested as an all soft tissue quadriceps tendon autograft.
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Abstract
Background
An evaluation of quadriceps tendon (QT) morphology preoperatively is an important step when selecting an individually appropriate autograft for anterior cruciate ligament (ACL) reconstruction. However, to our knowledge, there are no studies that have assessed the morphology of the entire QT in an ACL-injured knee preoperatively using ultrasound.
Purpose
We aimed to investigate the morphological characteristics of the QT using preoperative ultrasound in ACL-injured knees.
Methods
A total of 35 patients (mean age, 26.2 years) with a diagnosed ACL tear undergoing primary ACL reconstruction were prospectively included. Using ultrasound, short-axis images of the QT were acquired in 10-mm increments from 30 to 100 mm proximal to the superior pole of the patella. The length of the QT was determined by 2 contiguous images that did and did not contain the rectus femoris muscle belly. The width of the superficial and narrowest parts of the QT, the thickness of the central and thickest parts of the QT, and the cross-sectional area at the central 10 mm of the superficial QT width were measured at each assessment location. The estimated intraoperative diameter of the QT autograft was calculated using a formula provided in a previous study.
Results
There were no significant relationships between QT morphology and any of the demographic data collected. The length of the QT was less than 70 mm in 42.9% of patients (15/35). The width, thickness, cross-sectional area, and estimated intraoperative diameter of the QT autograft were significantly greater at 30 mm than at 70 mm proximal to the superior pole of the patella.
Conclusion
Preoperative ultrasound may identify a QT that is too small for an all–soft tissue autograft in ACL reconstruction. Furthermore, harvesting a QT with a fixed width may result in autografts that are smaller proximally than they are distally. Assessing the morphology of the QT preoperatively using ultrasound may help surgeons to adequately reconstruct the native length and diameter of the ACL with a QT autograft.