Key points are not available for this paper at this time.
PURPOSE: The objective of this study was to compare the ultimate tissue strength of the rectus femoris (RF) and patellar tendons using paired soft-tissue grafts obtained from fresh organ donors, simulating clinical graft preparation. METHODS: Fourteen paired RF and patellar tendon (PT) grafts were harvested from seven organ donors and tested within 12 h postmortem. The RF was folded and mounted as a double-stranded graft to simulate its clinical use. All grafts underwent uniaxial tensile testing using a standardised protocol. Primary outcomes included ultimate stress (MPa), load to failure (N) and elongation at failure (%). Data distribution was assessed with the Shapiro-Wilk test, and paired t-tests or Wilcoxon signed-rank tests were applied accordingly. A post hoc power analysis was conducted to determine the minimum detectable difference in stress with the given sample size. RESULTS: Ultimate stress did not differ significantly between RF and PT grafts (46.4 ± 10.5 MPa vs. 52.9 ± 9.7 MPa, p = 0.184). RF grafts showed significantly lower load to failure (885.9 ± 52.3 N vs. 1278.7 ± 207.5 N, p < 0.001) and greater elongation (1.2 ± 0.2% vs. 0.2 ± 0.1%, p < 0.001). CONCLUSION: This study found that the double-stranded RF tendon exhibits ultimate tissue strength comparable to the patellar tendon, despite differences in load to failure and elongation. These results highlight the RF as a biomechanically viable graft option that merits further investigation. Given its consistent dimensions and soft-tissue-only harvest, the RF tendon represents a reproducible and potentially less invasive alternative for knee ligament reconstruction. LEVEL OF EVIDENCE: N/A.
Pineda et al. (Tue,) studied this question.