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DOI: 10.1055/s-0042-1750364
Biomechanical Assessment of the Prepatellar Quadriceps Continuation
Article in several languages: español | English Funding The authors declare that they have received no funding pertaining to the performance of the present study.
Abstract
Objective To determine the ultimate tensile strength (UTS) of the prepatellar quadriceps continuation (PQC).
Materials and Methods A human cadaveric study was performed. Ten fresh-frozen specimens were used. The proximal and medial thirds of the anterior cortex of the patella were used to assess the mechanical properties of the PQC. In each specimen, transverse section areas measuring 0.2 cm2 (A1) and 1 cm2 (A2) were studied. A gradual load was applied to determine the UTS.
Results The median UTS of A1 was of 232.56 N (range: 141.23 N to 295.33 N), and that of A2 was of 335.30 N (range: 216.45 N to 371.40 N). The increment in UTS was significant between the 2 areas (p = 0.006).
Conclusions The clinical significance of the present study lies in the fact that it shows that the PQC is a strong tissue that can be a safe anchor for reconstruction around the patella. A relatively small area supports at least 140 N, and, as the area grows, the UTS increases as well.
Level of evidence Biomechanical study.
Availability of Data
The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Author's contributions
CI: contributed with the original idea, conceived the study, drafted the paper, and performed a critical review of the final paper. RS: performed the biomechanical testing. MI: coordinated and supervised the management of the cadaver specimens. RN: performed a critical review of the final paper. MB: performed the data analysis, literature review and drafted the manuscript. All authors have read and approved the final submitted manuscript.
Publication History
Received: 28 March 2021
Accepted: 10 May 2022
Article published online:
11 July 2022
© 2022. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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Referencias
- 1 Waligora AC, Johanson NA, Hirsch BE. Clinical anatomy of the quadriceps femoris and extensor apparatus of the knee. Clin Orthop Relat Res 2009; 467 (12) 3297-3306
- 2 Majeed H, dos Remedios I, Datta P, Griffiths D. Prepatellar continuation rupture: Report of an unusual case. Knee 2014; 21 (05) 979-981
- 3 Evans EJ, Benjamin M, Pemberton DJ. Fibrocartilage in the attachment zones of the quadriceps tendon and patellar ligament of man. J Anat 1990; 171: 155-162
- 4 Eyal S, Blitz E, Shwartz Y, Akiyama H, Schweitzer R, Zelzer E. On the development of the patella. Development 2015; 142 (10) 1831-1839
- 5 Dwek JR. The periosteum: what is it, where is it, and what mimics it in its absence?. Skeletal Radiol 2010; 39 (04) 319-323
- 6 Claes T, Claes S, De Roeck J, Claes T. Prepatellar Friction Syndrome: a common cause of knee pain in the elite cyclist. Acta Orthop Belg 2015; 81 (04) 614-619
- 7 Teixeira PA, Lecocq S, Moisei A, Chanson A, Louis M, Blum A. Sleeve-like avulsion fracture of the superior pole of the patella in a healthy adult. Diagn Interv Imaging 2013; 94 (01) 108-111
- 8 Wangwinyuvirat M, Dirim B, Pastore D. et al. Prepatellar quadriceps continuation: MRI of cadavers with gross anatomic and histologic correlation. AJR Am J Roentgenol 2009; 192 (03) W111-6
- 9 Dao Q, Chen DB, Scott RD. Proximal patellar quadricepsplasty realignment during total knee arthroplasty for irreducible congenital dislocation of the patella: a report of two cases. J Bone Joint Surg Am 2010; 92 (14) 2457-2461
- 10 Madigan R, Wissinger HA, Donaldson WF. Preliminary experience with a method of quadricepsplasty in recurrent subluxation of the patella. J Bone Joint Surg Am 1975; 57 (05) 600-607
- 11 Criscenti G, De Maria C, Sebastiani E. et al. Material and structural tensile properties of the human medial patello-femoral ligament. J Mech Behav Biomed Mater 2016; 54: 141-148
- 12 Marot V, Sanchis-Alfonso V, Perelli S. et al. Isolated reconstruction of medial patellofemoral ligament with an elastic femoral fixation leads to excellent clinical results. Knee Surg Sports Traumatol Arthrosc 2021; 29 (03) 800-805
- 13 Placella G, Speziali A, Sebastiani E, Morello S, Tei MM, Cerulli G. Biomechanical evaluation of medial patello-femoral ligament reconstruction: comparison between a double-bundle converging tunnels technique versus a single-bundle technique. Musculoskelet Surg 2016; 100 (02) 103-107
- 14 Green W. Quadricepsplasty in Treatment of Recurrent Subluxation of the Patella. Zit nach Madigan.
- 15 Vivod G, Verdonk P, Drobnič M. Long-term clinical and radiographic outcome of patello-femoral realignment procedures: a minimum of 15-year follow-up. Knee Surg Sports Traumatol Arthrosc 2014; 22 (11) 2747-2755
- 16 Vacariu A, Studer K, Rutz E, Camathias C. High failure rate 10.8 years after vastus medialis transfer and lateral release (Green's quadricepsplasty) for recurrent dislocation of the patella. Arch Orthop Trauma Surg 2020; 140 (10) 1349-13579
- 17 Kelly MA. Proximal realignment and medial tibial tubercle transfer. Oper Tech Sports Med 1999; 7 (02) 76-80