Morphology of the patellar tendon and its insertion sites using three-dimensional computed tomography: A cadaveric study

• Published in: The knee 2019-03, Vol.26 (2), p.302-309
• Main Authors: Oikawa, Ryunosuke, Tajima, Goro, Yan, Jun, Maruyama, Moritaka, Sugawara, Atsushi, Oikawa, Shinya, Saigo, Takaaki, Takahashi, Hirotaka, Doita, Minoru
• Format: Article
• Language: English
• Subjects: Anterior cruciate ligament reconstruction; Bone grafts; Bone surgery; Bone–patellar tendon–bone graft; Cadavers; Computed tomography; Digital imaging; Insertion; Knee; Medical imaging; Morphology; NMR; Nuclear magnetic resonance; Patellar tendon; Software; Tomography
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2018.12.002

To clarify, with three-dimensional (3D) images, the morphological properties of the patellar tendon and both of its insertion sites. Thirty-two human cadaveric left knees were evaluated, and 3D computed tomography images were created. These images were used to analyse the morphology of both insertion sites of the patellar tendon, and the width, length and thickness of each region of the patellar tendon. The insertion sites of the patellar tendon on the patellar and tibial sides were V-shaped and crescent-shaped, respectively, with the respective bony apexes located at 44.5 ± 2.2% (standard deviation) and 35.5 ± 2.8% of the tendon width from its medial edge. The proximal, central and distal widths of the patellar tendon were 29.9 ± 2.7 mm, 27.3 ± 2.5 mm and 25.0 ± 2.4 mm, respectively. The length of the patellar tendon was shortest at 40.6% ± 6.7% of the central width and gradually became longer toward both edges. The patellar tendon was thickest in the central portion of 40–75% and gradually became thinner toward both edges. The morphological properties of the patellar tendon and its insertion sites on both the patellar and tibial sides were consistent. These findings indicate that the characteristics of the bone–patellar tendon–bone graft markedly depend on the location from which it is harvested, and that these characteristics contribute to predicting the length, width and shapes of the bone plugs of the graft when performing bone–patellar tendon–bone surgery.