ArticleJournal of experimental orthopaedics2016
New insight in the architecture of the quadriceps tendon.
Article in Journal of experimental orthopaedics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- Muscle Moment Arm-Joint Angle Relations in the Hip, Knee, and Ankle: A Visualization of Datasets.Annals of biomedical engineering · 2025Pooled it
- Musculoskeletal ultrasonography of lower extremity entheses in children and adolescents - a pilot study of normal B-mode and Doppler characteristics.Pediatric radiology · 2026Article
- Structural and Functional Principles in Quadriceps Reconstruction.Muscles (Basel, Switzerland) · 2026Review
- Several flat tendon graft types are viable options for flat superficial medial collateral ligament reconstructions-A biomechanical analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Factors Influencing Excessive Dynamic Genu Valgum and the Effect on Post-Landing Movement Patterns: A Cross-Discipline Narrative Review.Journal of functional morphology and kinesiology · 2026Review
- Bidirectional Tendon Strip: A Rectus Femoris Graft Harvesting Technique for Anterior Cruciate Ligament Reconstruction.Arthroscopy techniques · 2025Article
- A Simple, Anatomical, and Reproducible Technique for Harvesting a Partial-Thickness Layered Rectangular Quadriceps Tendon-Bone Autograft: Using Standard Surgical Instruments.Arthroscopy techniques · 2025Article
- Systematic Review and Prevalence Meta-Analysis of Quadriceps Femoris Morphology: Significance of the Quadriceps Tendon in Anterior Cruciate Ligament Reconstruction.Journal of functional morphology and kinesiology · 2025Review
- The rectus abdominis tendon insertion to the pubic bone and its clinical implications: A cadaveric study.SICOT-J · 2025Article
- Arthritis or an Adjacent Fascial Response? A Case Report of Combined Pyomyositis and Aseptic Arthritis.Case reports in rheumatology · 2024Article
- The accessory heads of the quadriceps femoris muscle may affect the layering of the quadriceps tendon and potential graft harvest lengths.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Complete Distal Rupture of the Rectus Femoris in an Elite Football Player: A Non-operative Treatment.Cureus · 2023Article
- Graft-Specific Surgical and Rehabilitation Considerations for Anterior Cruciate Ligament Reconstruction with the Quadriceps Tendon Autograft.International journal of sports physical therapy · 2023Article
- Additional head of the rectus femoris muscle: a case report.Surgical and radiologic anatomy : SRA · 2022Article
- The relationship between additional heads of the quadriceps femoris, the vasti muscles, and the patellar ligament.BioMed research international · 2022Article
- Anatomy, Morphology and Function of the Tensor of Vastus Intermedius: A Systematic Review.Journal of functional morphology and kinesiology · 2021Review
- The development of the tensor vastus intermedius during the human embryonic period and its clinical implications.Journal of anatomy · 2021Article
- Morphometric analysis of vastus medialis oblique muscle and its influence on anterior knee pain.Anatomy & cell biology · 2021Article
- Gross anatomical investigation of the muscular head between the vastus lateralis and intermedius in the Japanese population: a cadaver study.Anatomical science international · 2021Article
- The fifth head of quadriceps femoris: for sure?Surgical and radiologic anatomy : SRA · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPublished 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.
methodsTen 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.
resultsSix 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.
conclusionsThe 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.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.