The anatomical properties of the indirect head of the rectus femoris tendon: a cadaveric study with clinical significance for labral reconstruction surgery

Atzmon, Ran; Sharfman, Zachary T.; Atoun, Ehud; Sampson, Thomas; Amar, Eyal; Rath, Ehud

doi:10.1007/s00402-019-03293-6

Cited by 12 publications

(13 citation statements)

References 22 publications

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“…In agreement with our results, they found no statistical differences in tendon measurements and angulation of the IT between the left and right sides nor between men and women (Moraux A et al, 2015). Although Atzmon et al (2020) suggested that musculoskeletal structures could evolve with age (Atzmon R et al, 2020), their results did not show any statistical differences according to that parameter. In addition, in this study, no statistically significant differences were found between the two studied different football disciplines (association football and futsal) or between lateral dominance, suggesting no adaptive variation of the PTC morphology to the sporting activity.…”

Section: Discussionsupporting

confidence: 91%

“… Atzmon et al (2020) analyzed the IT in an anatomical study with human cadavers to assess its clinical applications in labral surgical reconstruction. The authors described different PTC variables, among which the angle between the longitudinal axis of the muscle belly of the RF and the free IT (mean 135.8°) and the angle between the free IT and its footprint are included ( Atzmon R et al, 2020 ). The latter cannot be measured by MRI, given the poor definition of the craniocaudal margins of the footprint portion.…”

Section: Discussionmentioning

confidence: 99%

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Measuring direct and indirect tendon parameters to characterize the proximal tendinous complex of the rectus femoris in football and futsal players

Mechó

Ortega²,

Pruna³

et al. 2023

Front. Physiol.

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Objective: To present unprecedented radiological parameters that characterize the angle between the direct and indirect tendons of the proximal rectus femoris (RF) and its inclinations and to evaluate the population variability according to demographic variables.Materials and methods: From September 2019 to July 2021, using MRI multiplanar reconstructions of the proximal thigh/hip, two blinded radiologists measured the direct and indirect tendon angle and the inclination of each tendon in different planes. The intra- and inter-observer agreements were assessed with Bland–Altman analysis and intraclass correlation coefficient (ICC). The correlations between radiological parameters and demographic variables were evaluated using linear regression, Student’s t-test, and analysis of variance.Results: We performed 112 thigh/hip MRI scans on 91 football players of different age, gender, and disciplines (football and futsal). For observer 1 (the reference), the mean direct and indirect tendon angle was 56.74° ± 9.37, the mean indirect tendon slope was −7.90° ± 7.49, and the mean direct tendon slope was 22.16° ± 5.88. The three measurements showed inter- and intra-observer agreement (mean differences ∼0). No correlation was observed between age and the parameters. Likewise, no statistically significant differences were found for gender, dominant limb, examined limb, and sport.Conclusion: There is an inter- and intra-observer agreement in the measurements of the direct and indirect tendon angle and the inclination of each tendon. There is population variability in the proximal tendinous complex unrelated to demographic factors. These results allow further detection of morphological patterns that represent a risk factor for lesions in the RF in professional football and futsal players and other sports.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Measuring direct and indirect tendon parameters to characterize the proximal tendinous complex of the rectus femoris in football and futsal players

Mechó

Ortega²,

Pruna³

et al. 2023

Front. Physiol.

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“…The complex anatomical relationships of these arteries to the musculature surrounding the hip joint make them susceptible to injury during hip surgery [ 13 ]. The direct head of the rectus tendon retained in group B of this study has a broad insertion on the anterior inferior iliac spine [ 21 , 22 ]. The anterior inferior iliac spine is adjacent to the lateral circumflex femoral artery and femoral nerve.…”

Section: Discussionmentioning

confidence: 99%

Modified Smith–Petersen approach with rectus-sparing reduces severe avascular necrosis for developmental dysplasia of the hip at walking age: minimum 5-year follow-up

et al. 2022

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Background Developmental dysplasia of the hip (DDH) is one of the most common orthopedic malformations in children. Open reduction for DDH at walking age remains a major concern. The goal of this study is to evaluate the mid-term effect of a modified Smith–Petersen approach which preserves the rectus femoris on DDH at walking age, in particular avascular necrosis (AVN). Methods A retrospective review of DDH patients aged between 12 and 24 months was carried out between January 2010 and June 2016. Open reduction through the Smith–Petersen approach (Group A) and modified Smith–Petersen approach, which preserves the rectus femoris (Group B), were both used. Measurement of hip geometry included acetabular index, the International Hip Dysplasia Institute classification, and AVN degree. Clinical records included operation time, bleeding volume, and abduction angle. Results There were 101 children (119 hips) with DDH who met the inclusion criteria. There were 66 hips in Group A and 53 in Group B. The mean surgical age at open reduction was 17.0 ± 2.4 months, with a mean 104.9 ± 19.5 months at last follow-up. There was no statistical difference in surgical age between the two groups (17.2 vs. 16.4 months). There was no significant difference in the incidence of all types of clinically significant AVN between group A and group B (27.3 vs. 18.9%), but the incidence of severe AVN was lower in group B (19.7 vs. 5.7%, P = 0.026). In addition, the lower the age at the time of open reduction, the lower the severity of AVN (P = 0.002). Conclusions These mid-term data suggest that the modified Smith–Petersen approach with rectus-sparing could reduce severe AVN more than the classical Smith–Peterson approach in open reduction in DDH at walking age. In addition, early open reduction can reduce the postoperative degree of AVN.

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“…Cadaveric studies show that the mean length available for graft harvest is 46.1 mm while the average labral tear ranges from 28 to 39 mm44. In addition, the native labral width is 2.7 to 5.5 mm while the IHRF ranges from 18.8 to 24.6 mm 43 . Because of its size relative to the native labrum, less than half of the intra-articular distal radial fracture tendon typically needs to be used, leaving the remaining tendon functional.…”

Section: Autograft Optionsmentioning

confidence: 99%

Graft Options for Hip Labral Reconstruction

et al. 2022

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Arthroscopic hip labral reconstruction is a complex procedure which is growing in use as indications, techniques, and surgical expertise advance.Graft selection is an important component of labral reconstruction based on relative advantages and disadvantages of available types of autografts and allografts.The ideal graft should mimic the native acetabular labrum form and function while also being affordable, readily available, and associated with low morbidity.High rates of patient satisfaction and positive patient-reported outcomes have been reported after labral reconstruction using several graft types.

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The anatomical properties of the indirect head of the rectus femoris tendon: a cadaveric study with clinical significance for labral reconstruction surgery

Cited by 12 publications

References 22 publications

Measuring direct and indirect tendon parameters to characterize the proximal tendinous complex of the rectus femoris in football and futsal players

Measuring direct and indirect tendon parameters to characterize the proximal tendinous complex of the rectus femoris in football and futsal players

Modified Smith–Petersen approach with rectus-sparing reduces severe avascular necrosis for developmental dysplasia of the hip at walking age: minimum 5-year follow-up

Graft Options for Hip Labral Reconstruction

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