scholarly journals MR imaging of the quadriceps femoris tendon: distal tear characterization and clinical significance of rupture types

2021 ◽  
Author(s):  
Anna L. Falkowski ◽  
Jon A. Jacobson ◽  
Michael T. Hirschmann ◽  
Vivek Kalia
Keyword(s):  
Mr Imaging ◽  
Vastus Lateralis ◽  
Case Series ◽  
Rectus Femoris ◽  
Quadriceps Tendon ◽  
Quadriceps Femoris ◽  
Vastus Medialis ◽  
Bony Avulsion ◽  
Tendon Tears ◽  
Reader Reliability

Abstract Objective To characterize quadriceps femoris tendon tears on magnetic resonance (MR) imaging regarding tear extent, location, and presence of bony avulsion. Materials and methods IRB approval was obtained and informed consent was waived for this retrospective case series. Electronic medical records from all patients in our hospital system were searched for keywords: knee MR imaging, and quadriceps tendon rupture or tear. MRI studies were randomized and independently evaluated by two fellowship-trained musculoskeletal radiologists. MR imaging was used to characterize each individual quadriceps tendon as having tendinosis, tear (location, partial versus complete, size, and retraction distance), and bony avulsion. Knee radiographs were reviewed for presence or absence of bony avulsion. Descriptive statistics and inter-reader reliability (Cohen’s Kappa and Wilcoxon-signed-rank test) were calculated. Results Fifty-two patients with 53 quadriceps tears were evaluated (45 males, 7 females; mean age: 51 ± 13 years). The vastus intermedius (VI) tendon more often incurred a partial rather than a complete tear (39.6% vs. 37.7%), while the rectus femoris (RF), vastus medialis (VM), and vastus lateralis (VL) incurred complete tears more commonly (64.2–66%). Subjects with bony avulsion on radiographs had higher-grade tears of the RF, VM, and VL tears (p = 0.020–0.043) but not the VI. Most tendons tore at or immediately proximal to the patella (84.8–93.6%). Gaps in retracted torn tendons measured between 2.3 and 2.7 cm. Inter-reader reliability was substantial to almost perfect (κ = 0.624–0.953). Conclusion Quadriceps femoris tendon tears most commonly involve the RF or VL/VM layers usually in proximity to the patella. A bony avulsion correlates with a more extensive tear. Key Points • Quadriceps femoris tendon tears most commonly involve the rectus femoris or vastus lateralis/vastus medialis layers. • A rupture of the quadriceps femoris tendon usually occurs in proximity to the patella. • A bony avulsion of the patella correlates with a more extensive tear of the superficial and middle layers of the quadriceps tendon.

scholarly journals The Relationship Between Additional Heads of the Quadriceps Femoris, the Vasti Muscles and the Patellar Ligament

2021 ◽  
Author(s):  
Łukasz Olewnik ◽  
Kacper Ruzik ◽  
Bartłomiej Szewczyk ◽  
Michał Podgórski ◽  
Paloma Aragonés ◽  
...  
Keyword(s):  
Vastus Lateralis ◽  
Rectus Femoris ◽  
Quadriceps Femoris ◽  
The Other ◽  
Lower Limbs ◽  
Patellar Ligament ◽  
Vastus Medialis ◽  
Vastus Intermedius ◽  
Deep Layers ◽  
The Relationship

Abstract Introduction: The quadriceps femoris consists of four muscles: the rectus femoris, vastus medialis, vastus intermedius and vastus lateralis. However, the effect of additional quadriceps femoris heads on the vasti muscles and patellar ligaments is unknown.Materials and Methods: One hundred and six lower limbs (34 male and 19 female cadavers) fixed in 10% formalin were examined.Results: On all lower extremities, the vastus lateralis consisted of superficial, intermediate and deep layers. The vastus medialis, on the other hand, consisted of only the longus and obliquus layers. Additional quadriceps femoris heads affected both the vasti muscles and the patellar ligaments.Conclusion: There is a strong correlation between the presence of accessory quadriceps femoris heads and effects on vasti muscles and patellar ligament.

scholarly journals Qualitative and Quantitative Anatomy of the Human Quadriceps Tendon in Young Cadaveric Specimens

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110373
Author(s):  
Marc Strauss ◽  
Mitchell L. Kennedy ◽  
Alex Brady ◽  
Gilbert Moatshe ◽  
Jorge Chahla ◽  
...  
Keyword(s):  
Vastus Lateralis ◽  
Cruciate Ligament ◽  
Rectus Femoris ◽  
Middle Layer ◽  
Quadriceps Tendon ◽  
Proximal Part ◽  
Superficial Layer ◽  
Measuring System ◽  
Vastus Medialis ◽  
Median Length

Background: A detailed understanding of the anatomy of the quadriceps tendon (QT) is clinically relevant, owing to its increased use as a graft in anterior cruciate ligament reconstruction. Purpose: To qualitatively and quantitatively describe the anatomy of the QT in younger adult specimens. Study Design: Descriptive laboratory study. Methods: A total of 18 nonpaired cadaveric knees with a mean age of 30.1 years (range, 18-38 years) were utilized for this study. A 3-dimensional coordinate measuring system was used to assess the structural relationships between the different layers of the QT and their attachments to the patella, and QT thickness was measured medially, centrally, and laterally at 2-cm intervals from the patellar eminence line (PEL; defined as a straight line between the medial and lateral patellar eminences) and proximally. Results: In all specimens, 3 distinct layers formed the QT. The first (superficial) layer was formed by the rectus femoris, which was fused to the second layer with an unclearly defined direct attachment to the patella. The median length of the QT was 86.9 mm (range, 68.4-98.9 mm). The second (middle) layer consisted of the vastus medialis and vastus lateralis and was found to have fibers running in an oblique direction that attached on the patella. A “fuse point,” where the proximal part of the rectus femoris started to merge to the second layer, was identified at a median of 48.7 mm (range, 27.9-62.6 mm) from the PEL. The third (deep) layer consisted of the vastus intermedius. The median thickness of the graft centrally at 20, 40, 60, 80, and 100 mm from the PEL was 8.5, 7.2, 7.5, 6.5, and 5.4 mm, respectively. Conclusion: Overall, 3 different layers of the QT were consistently found in all specimens. The first layer was fused with the second layer, and the direction of the fibers of the second layer or the vastus medialis and vastus lateralis was oblique. The median length of the QT was 86.9 mm, and the thickness of the tendon diminished proximally. Clinical Relevance: This study allows for a better understanding of QT anatomy when harvesting the tendon as a graft for ligamentous reconstruction.

Cross-sectional comparison of age-related changes in the quadriceps femoris in Japanese basketball players

2017 ◽  
Vol 0 (0) ◽  
Author(s):  
Yuta Sekine ◽  
Norikazu Hirose
Keyword(s):  
Vastus Lateralis ◽  
Muscle Thickness ◽  
Rectus Femoris ◽  
Quadriceps Femoris ◽  
Vastus Medialis ◽  
Basketball Players ◽  
Cross Sectional ◽  
Age Related ◽  
Vastus Intermedius ◽  
Age Related Changes

Abstract Background This study examines age-related changes in the quadriceps femoris (QF), subdivided into the vastus medialis oblique (VMO), vastus medialis (VM), rectus femoris (RF), vastus intermedius (VI) and vastus lateralis (VL) in basketball players. Subjects Seventy male basketball players were divided into four groups according to age (12–13, 14–15, 16–17, and 18–20 years). Methods Ultrasonography was used to measure muscle architecture of the VMO, VM, RF, VI and VL. We created cubic approximate expressions and calculated inflexion points to evaluate peak growth age of each muscle head. Results Significant interactions were observed for all QF parts (p < 0.01–0.001). Muscle thickness (MT) in all QF parts was significantly lower in 12–13-year olds than in 18–20-year olds (p < 0.01–0.001). Significant differences were recognised between 12–13 and 16–17-year olds in VM (p < 0.001), RF (p < 0.001) and VL (p = 0.007). MT was significantly lower in 14–15-year olds than in 16–17-year olds in the VM (p = 0.007) and RF (p = 0.026) and in 18–20 year olds in the VM (p < 0.001), RF (p = 0.036) and VI (p < 0.001). Peak growth age was estimated for each QF part (VMO, 155.0 months; VM, 187.8 months; RF, 212.2 months, VI, 188.9 months; VL, 181.1 months). Conclusion QF parts have different growth rates due to differing functions in each muscle head.

Muscle-specific atrophy of the quadriceps femoris with aging

2001 ◽  
Vol 90 (6) ◽  
pp. 2070-2074 ◽  
Author(s):  
T. A. Trappe ◽  
D. M. Lindquist ◽  
J. A. Carrithers
Keyword(s):  
Vastus Lateralis ◽  
Rectus Femoris ◽  
Quadriceps Femoris ◽  
Aging Research ◽  
Cross Sectional ◽  
Men And Women ◽  
Younger Women ◽  
Vastus Intermedius ◽  
Aging Men ◽  
Old Men

We examined the size of the four muscles of the quadriceps femoris in young and old men and women to assess whether the vastus lateralis is an appropriate surrogate for the quadriceps femoris in human studies of aging skeletal muscle. Ten young (24 ± 2 yr) and ten old (79 ± 7 yr) sedentary individuals underwent magnetic resonance imaging of the quadriceps femoris after 60 min of supine rest. Volume (cm3) and average cross-sectional area (CSA, cm2) of the rectus femoris (RF), vastus lateralis (VL), vastus intermedius (VI), vastus medialis (VM), and the total quadriceps femoris were decreased ( P < 0.05) in older compared with younger women and men. However, percentage of the total quadriceps femoris taken up by each muscle was similar ( P > 0.05) between young and old (RF: 10 ± 0.3 vs. 11 ± 0.4; VL: 33 ± 1 vs. 33 ± 1; VI: 31 ± 1 vs. 31 ± 0.4; VM: 26 ± 1 vs. 25 ± 1%). These results suggest that each of the four muscles of the quadriceps femoris atrophy similarly in aging men and women. Our data support the use of vastus lateralis tissue to represent the quadriceps femoris muscle in aging research.

Decrease in maximal voluntary contraction by tonic vibration applied to a single synergist muscle in humans

2000 ◽  
Vol 89 (4) ◽  
pp. 1420-1424 ◽  
Author(s):  
Motoki Kouzaki ◽  
Minoru Shinohara ◽  
Tetsuo Fukunaga
Keyword(s):  
Maximal Voluntary Contraction ◽  
Vastus Lateralis ◽  
Rectus Femoris ◽  
Knee Extension ◽  
Voluntary Contraction ◽  
Vastus Medialis ◽  
Force Development ◽  
Ia Afferent ◽  
Before And After ◽  
Integrated Emg

The purpose of the study was to examine the effect of prolonged tonic vibration applied to a single synergist muscle on maximal voluntary contraction (MVC) and maximal rate of force development (dF/d t max). The knee extension MVC force and surface electromyogram (EMG) from the rectus femoris (RF), vastus lateralis (VL), and vastus medialis (VM) during MVC were recorded before and after vibration of RF muscle at 30 Hz for 30 min. MVC, dF/d t max, and the integrated EMG (iEMG) of RF decreased significantly after prolonged tonic vibration in spite of no changes in iEMG of VL and VM. The present results indicate that MVC and dF/d t max may be influenced by the attenuated Ia afferent functions of a single synergist muscle.

Influence of contraction intensity, muscle, and gender on median frequency of the quadriceps femoris

2001 ◽  
Vol 90 (3) ◽  
pp. 804-810 ◽  
Author(s):  
Danny M. Pincivero ◽  
Robert M. Campy ◽  
Yuliya Salfetnikov ◽  
Ashley Bright ◽  
Alan J. Coelho
Keyword(s):  
Fiber Type ◽  
Vastus Lateralis ◽  
Morphological Variability ◽  
Power Spectral Analysis ◽  
Rectus Femoris ◽  
Quadriceps Femoris ◽  
Median Frequency ◽  
Power Spectral ◽  
And Gender ◽  
Voluntary Contractions

The purpose of this study was to assess the effects of contraction intensity, gender, and muscle on median frequency of the three superficial portions of the quadriceps femoris muscle. Thirty healthy volunteers were assessed for isometric electromyogram activity of the vastus medialis (VM), vastus lateralis (VL), and rectus femoris (RF) muscles with the knee at 60° flexion. Subjects performed 5-s isometric contractions at 10, 20, 30, 40, 50, 60, 70, 80, and 90% of the average of three maximal voluntary contractions. Median frequency ( fmed) of the three muscles was assessed through a power spectral analysis performed over 11 consecutive 512-ms epochs overlapping each other by one-half their length. The fmedfor each of the 11 epochs was then determined, followed by calculation of the mean and SD. The major findings of this study demonstrated that overall fmedwas significantly highest for the VL and lowest for the VM, whereas RF fmedwas between that of the other two muscles. Similar findings were observed for fmedvariability as the VL was significantly higher than the VM and RF, with no gender differences or differences between the latter two muscles. The results demonstrate that the largest change in fmedas a function of contraction intensity occurred for the VL in men (18.6%) and women (7.6%). These findings suggest that muscle fiber-type homogeneity may exist in the VM and RF, which displayed negligible changes in fmed, whereas the VL may possess greater morphological variability.

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