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New insight in the architecture of the quadriceps tendon

Overview of attention for article published in Journal of Experimental Orthopaedics, November 2016
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Title
New insight in the architecture of the quadriceps tendon
Published in
Journal of Experimental Orthopaedics, November 2016
DOI 10.1186/s40634-016-0068-y
Pubmed ID
Authors

Karl Grob, Mirjana Manestar, Luis Filgueira, Timothy Ackland, Helen Gilbey, Markus S. Kuster

Abstract

Published data regarding the structure of the quadriceps tendon are diverse. Dissection of the quadriceps muscle group revealed that beside the rectus femoris, vastus lateralis, vastus intermedius and vastus medialis a fifth muscle component- named the tensor vastus intermedius consistently fused into quadriceps tendon. It can be hypothesized that all these elements of the extensor apparatus of the knee joint must also be represented in the quadriceps tendon. This study investigated the multi-layered quadriceps tendon with special emphasis on all components of the quadriceps muscle group including the newly discovered tensor vastus intermedius. Ten cadaveric lower limbs were dissected. All muscle bellies of the extensor apparatus of the knee joint were identified and traced distally until they merged into the quadriceps tendon. Connections between the different aponeurotic layers of each muscle were studied from origin to insertion. The fusing points of each layer were marked. Their distance to the patella and the distances between the fusing points were measured. Six elements of the quadriceps muscle group form a tri-laminar structure of the quadriceps tendon. The intermediate layer could be further sub-divided. The elements of the quadriceps tendon are 1. lateral aponeurosis of the vastus intermedius, 2. deep and 3. superficial medial aponeurosis of the vastus intermedius, 4. vastus lateralis, 5. tensor vastus intermedius and 6. rectus femoris. Even with differences in fiber direction - these elements join each other a certain distance proximal to the patella. All elements were fused over a region measuring 13 to 90 mm proximal to the patella. Lateral parts of the vastus intermedius formed the deepest layer of the quadriceps tendon. The superficial and deep layer of the medial vastus intermedius aponeurosis fused 56 mm (range, 30 to 90 mm) and 33 mm (range, 13 to 53 mm) above the patella with the aponeurosis of the tensor vastus intermedius and vastus lateralis respectively. Together they built the two-layered intermediate layer of the quadriceps tendon. The tendon of the rectus femoris forms the superficial layer. The vastus medialis inserts medially in all layers of the quadriceps tendon. Fibers of the lateral muscle components were oriented towards the medial, and fibers of the medial muscle components were oriented towards the lateral femoral condyle. The three-layered quadriceps tendon is formed by six elements. These are 1. lateral aponeurosis of the vastus intermedius, 2. deep and 3. superficial medial aponeurosis of the vastus intermedius, 4. vastus lateralis, 5. tensor vastus intermedius and 6. rectus femoris. These elements of the extensor apparatus join each other proximal to the patella in a complex onion-like architecture. Its two-layered intermediate layer shows variable fusions points. The vastus medialis contributes to the quadriceps tendon with its medial insertion into all layers of the quadriceps tendon.

Mendeley readers

The data shown below were compiled from readership statistics for 41 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 1 2%
Unknown 40 98%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 8 20%
Student > Bachelor 6 15%
Student > Master 5 12%
Lecturer 5 12%
Other 3 7%
Other 10 24%
Unknown 4 10%
Readers by discipline Count As %
Medicine and Dentistry 19 46%
Nursing and Health Professions 6 15%
Sports and Recreations 2 5%
Agricultural and Biological Sciences 1 2%
Pharmacology, Toxicology and Pharmaceutical Science 1 2%
Other 4 10%
Unknown 8 20%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 April 2018.
All research outputs
#11,406,526
of 12,829,119 outputs
Outputs from Journal of Experimental Orthopaedics
#57
of 72 outputs
Outputs of similar age
#234,606
of 269,556 outputs
Outputs of similar age from Journal of Experimental Orthopaedics
#1
of 1 outputs
Altmetric has tracked 12,829,119 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 72 research outputs from this source. They receive a mean Attention Score of 3.4. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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