RT Journal Article T1 The accessory heads of the quadriceps femoris muscle may affect the layering of the quadriceps tendon and potential graft harvest length A1 Olewnik, Lukasz A1 Zielinska, Nicole A1 Aragonés Maza, Paloma A1 Ruzik, Kacper A1 Paulsen, Friedrich A1 Borowski, Andrzej A1 La Prade, Robert F. AB PurposeThe aim of the study was to assess the quadriceps femoris system for the presence of additional layers.MethodsOne hundred and twenty-eight lower limbs fixed in 10% formalin were examined.ResultsFive types of quadriceps tendon layering were found based on the accessory heads of the quadriceps muscle. Type I (55%)—represented by four heads and four layers, and it was something new because standard orthopaedic textbooks described quadriceps tendon as a structure composed of only three layers. Type II (27.4%)—the first four layers were the same as in Type 1, but the accessory tendon of the fifth head of the quadriceps femoris muscle had the deepest attachments. Type III (10.9%)—this type included 6 heads of quadriceps femoris. It consisted of five layers. Type IV (3.1%)—this type included 7 quadriceps femoris heads. This type consisted of only four layers. Type V (3.1%)—this type included 8 heads of the quadriceps femoris heads. This type consist of 5 layers.ConclusionThe findings of this study provide a detailed anatomy of the quadriceps tendon including the accessory tendons of the accessory heads of the quadriceps tendon. The accessory heads of the quadriceps femoris muscle contribute to the layering of the quadriceps tendon. The second conclusion of this study is the development of safe distances depending on the types. Not all types are perfect for harvesting—Type IV seems to be the safest type, in turn Type V the most dangerous. PB Springer SN 0942-2056 YR 2023 FD 2023-11-06 LK https://hdl.handle.net/20.500.14352/107124 UL https://hdl.handle.net/20.500.14352/107124 LA eng NO Olewnik Ł, Zielinska N, Aragones P, Ruzik K, Paulsen F, Borowski A, et al. The accessory heads of the quadriceps femoris muscle may affect the layering of the quadriceps tendon and potential graft harvest lengths. Knee Surg Sports Traumatol Arthrosc [Internet]. 2023;31(12):5755–64. Available from: http://dx.doi.org/10.1007/s00167-023-07647-x DS Docta Complutense RD 21 abr 2025