Anat Cell Biol.  2023 Jun;56(2):191-199. 10.5115/acb.22.169.

Morphometry of the patellar tendon using a simple tracing method: a gold standard for anterior cruciate ligament reconstruction

• Latiff S
• Olateju OI

• KMID: 2544080
• DOI: http://doi.org/10.5115/acb.22.169

Abstract

The anterior cruciate ligament (ACL) is mostly damaged in sporting activities. To reconstruct the damaged ACL, a patellar tendon (PT) is often the most preferred graft due to its fast healing and bone integration i.e. bone-patellar tendon-bone graft. Suitability of the PT often depends on the morphometric profile of the tendon. This study reported on the harvestable surface area (SA) of the tendon using a simple tracing method. The PT of 79 adult formalin–fixed cadavers of South Africans of European Ancestry were dissected, and the margins of the PT were traced on a wax paper before the tracings were scanned. The SA, straight proximal width (SPW), curved proximal width (CPW), straight distal width (SDW), curved distal width (CDW) and length of tendon (LOT) from the digitized image of the PT was measured. In addition, the length of the lower limbs was measured to normalize the measurements. The results showed no significant side differences, and the measurements were not sexually dimorphic. A strong correlation was reported for SA vs. LOT, SPW vs. CPW and SDW vs. CDW for both sexes and sides. The presented morphological profile provides additional information on the usability of the graft and with respect to healing and recovery.

Keyword

Patellar ligament; Knee injuries; Autografts; Tendons; Anterior cruciate ligament reconstruction

Figure

• 

  Fig. 1 Illustrations of the PT tracings on the anterior compartment of the thigh showing (A) the exposed PT after removing the superficial structures, (B) the highlighted PT margins (i.e., its extent) with a permanent marker in order to improve visibility and tracing accuracy, (C) the PT tracing on a superimposed wax paper secured by coloured pins to assume the curvature of PT and (D) the digitized image of the traced tendon from which parameters were measured. PT, patellar tendon; P, patella; TT, tibial tuberosity; WaxP, wax paper; LOT, length of tendon; SPW, straight proximal width; CPW, curved proximal width; CDW, curved distal width; SDW, straight distal width; Prox, proximal; Med, medial.

• 

  Fig. 2 Superimposed line graphs showing the pattern of variations between the SA or the LLL of both limbs for each individual cadaver. Red arrows indicate where patterns of the measurements in both limbs of an individual are not visibly identical compared to the measurements of the LLL for both limbs of same individual. SA, surface area; LLL, length of lower limb.

Reference

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