Morphometric analysis of patella and patellar ligament: a cadaveric study to aid patellar tendon grafts

Purpose: Morphometric analysis of the patella and the patellar ligament is crucial in diagnosing and surgical corrections of knee injuries and patellofemoral joint disorders. Dimensions of the patella and the patellar ligament are frequently used in implant design and ACL reconstruction. This study aims to obtain detailed morphometric data on the patellar ligament and its localization based on gross anatomical dissections in the adult cadavers. Methods: The present study consisted of 50 lower limbs from formalin-fixed male adult cadavers aged about 70 years (45–85) belonging to the South Indian population. Total length of the quadriceps tendon, patellar height, patellar ligament height, proximal width, distal width and thickness of the patellar ligament were measured meticulously. Mean, standard deviation, median scores of each parameter were computed for groups using SPSS 16.0. Level of significance was considered as p < 0.05. Wilcoxon signed-rank test was used to compare the various parameters on the right and left limbs. The relationships between all parameters were analyzed using Spearman’s rank correlation test. Results: There was no statistically significant difference in the various measurements of the patella and patellar ligament between the right and left lower limbs. Patellar ligament length showed positive correlation with ligament thickness (r = 0.36; p = 0.078 for right limb and r = 0.33; p = 0.104 for left limb). Proximal width of ligament showed significant positive correlation with distal width (r = 0.41; p = 0.041 for right limb and r = 0.54; p = 0.006 for left limb). Conclusion: This morphometric data and analysis might be fundamental in understanding various knee conditions in situ and necessary to orthopedic surgeons for successful planning and execution for ACL reconstruction using patellar ligament graft and other patellofemoral joint disorders. Level of evidence: I.