The Effect of Medial Release of the Distal Patellar Tendon Insertion on Lateral Patella Translation and Residual Insertion Strength: A Cadaveric Study

Abstract Introduction The central ridge of the patella is the thickest area of patella and varies among patients. This cadaveric study identified the location and thickness of the bone at the central patella ridge for bone-patellar tendon-bone (BPTB) harvesting. Materials and methods Fifty cadaveric knees were assessed. First, the morphology, length, width, and location of the central patellar ridge were recorded. Then, we transversely cut the patella 25 mm from the lower pole and measured the thickness of the anterior cortex, cancellous bone, and cartilage from both the mid-patella and the central ridge location. Finally, the depth of the remaining cancellous bone at the mid-patella was compared to the bone at the central ridge. Results The location of the central-patellar ridge deviated medially from the mid-patella in 46 samples with an average distance of 4.36 ± 1 mm. Only 4 samples deviated laterally. The mean patella length was 41.19 ± 4.73 mm, and the width was 42.8 ± 5.25 mm. After a transverse cut, the remaining cancellous bone was significantly thicker at the central ridge compared to the bone at the mid-patella. Conclusions Most of the central patellar ridge deviated medially, approximately 4 mm from the mid-patella. Harvesting the graft from the central ridge would have more remaining bone compared to the mid-patella.

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Restoration of tensile properties at tendon insertion to bone by a patellar tendon-tibia autograft: An experimental study with canine infraspinatus

Journal of Shoulder and Elbow Surgery ◽

10.1016/s1058-2746(99)90103-9 ◽

1999 ◽

Vol 8 (6) ◽

pp. 628-633 ◽

Cited By ~ 7

Author(s):

Mitsuhiro Aoki ◽

Ei-ichi Uchiyama ◽

Kozo Ohtera ◽

Sei-ichi Ishii ◽

Sei-ii Ohtani ◽

...

Keyword(s):

Experimental Study ◽

Tensile Properties ◽

Patellar Tendon ◽

Tendon Insertion

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A Cadaveric Study of the Fibularis Longus: A Descriptive Study of Tendon Insertion and Curvature

The FASEB Journal ◽

10.1096/fasebj.2021.35.s1.02596 ◽

2021 ◽

Vol 35 (S1) ◽

Author(s):

Brandalynn Holland ◽

Barth Wright ◽

Micaela Motzko ◽

Edwin Glueck

Keyword(s):

Descriptive Study ◽

Cadaveric Study ◽

Tendon Insertion

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A Knee Size-Independent Parameter for Malalignment of the Distal Patellofemoral Joint in Children

Advances in Orthopedics ◽

10.1155/2019/3496936 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Ferdinand Wagner ◽

Günther Maderbacher ◽

Jan Matussek ◽

Boris M. Holzapfel ◽

Birgit Kammer ◽

...

Keyword(s):

Patellar Tendon ◽

Patellofemoral Joint ◽

Cruciate Ligament ◽

Independent Parameter ◽

Common Finding ◽

Tibial Tubercle ◽

Control Group ◽

Study Cohort ◽

Tendon Insertion ◽

Knee Size

Introduction. Patellar instability (PI) is a common finding in children. Current parameters describing patellofemoral joint alignment do not account for knee size. Additionally, most parameters utilize joint-crossing tibiofemoral landmarks and are prone to errors. The aim of the present study was to develop a knee size-independent parameter that is suitable for pediatric or small knees and determines the malpositioning of the distal patellar tendon insertion solely utilizing tibial landmarks. Methods. Sixty-one pediatric knees were included in the study. The tibial tubercle posterior cruciate ligament distance (TTPCL) was measured via magnetic resonance imaging (MRI). The tibial head diameter (THD) was utilized as a parameter for knee size. An index was calculated for the TTPCL and THD (TTPCL/THD). One-hundred adult knees were analyzed to correlate the data with a normalized cohort. Results. The THD was significantly lower in healthy females than in males (69.3 mm ± 0.8 mm vs. 79.1 mm ± 0.7 mm; p<0.001) and therefore was chosen to serve as a knee size parameter. However, no gender differences were found for the TTPCL/THD index in the healthy adult study cohort. The TTPCL/THD was significantly higher in adult PI patients than in the control group (0.301 ± 0.007 vs. 0.270 ± 0.007; p=0.005). This finding was repeated in the PI group when the pediatric cohort was analyzed (0.316 ± 0.008 vs. 0.288 ± 0.010; p=0.033). Conclusion. The TTPCL/THD index represents a novel knee size-independent measure describing malpositioning of the distal patellar tendon insertion determined solely by tibial landmarks.

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Effect of Tibial Plateau Leveling Osteotomy on Patellar Tendon Angle: A Radiographic Cadaveric Study

Veterinary Surgery ◽

10.1111/j.1532-950x.2010.00665.x ◽

2010 ◽

Vol 39 (4) ◽

pp. 418-424 ◽

Cited By ~ 11

Author(s):

Kevin A. Drygas ◽

Antonio Pozzi ◽

Robert L. Goring ◽

MaryBeth Horodyski ◽

Daniel D. Lewis

Keyword(s):

Patellar Tendon ◽

Tibial Plateau ◽

Cadaveric Study

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The Relationship Between Physical Examination and Ultrasonography of Large Entheses of the Achilles Tendon and Patellar Tendon Origin

The Journal of Rheumatology ◽

10.3899/jrheum.190169 ◽

2019 ◽

Vol 47 (7) ◽

pp. 1026-1030 ◽

Cited By ~ 4

Author(s):

Sibel Zehra Aydin ◽

Sibel Bakirci ◽

Esen Kasapoglu ◽

Concepcion Castillo-Gallego ◽

Fatıma Arslan Alhussain ◽

...

Keyword(s):

Physical Examination ◽

Achilles Tendon ◽

Patellar Tendon ◽

Anatomical Site ◽

Plantar Aponeurosis ◽

The Us ◽

Doppler Signals ◽

Us Findings ◽

Tendon Insertion ◽

The Relationship

Objective.To investigate the relationship between physical examination (PE) and sonographic features of enthesitis, based on anatomical sites.Methods.The analysis was done using merged raw data of 3 studies on 2298 entheses.Results.Patients with clinical Achilles enthesitis had more abnormalities on ultrasound (US): hypoechogenicity, p < 0.001; thickening, p = 0.001; Doppler signals, p = 0.002; and erosions, p = 0.02. The patellar tendon origin also correlated with PE but distal patellar tendon insertion and plantar aponeurosis were uncoupled from the US.Conclusion.The relationship between clinical and sonographic findings for large entheses is dependent on the anatomical site. For the patellar tendon origin and Achilles entheses, PE is significantly linked to US findings.

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