Tensor of the vastus intermedius muscle: anatomy, function, and clinical implications

The Tensor of the Vastus Intermedius (TVI) is a recently described anatomical structure located between the Vastus Lateralis and the Vastus Intermedius, components of the quadriceps femoris. This study conducted a systematic literature review, following PRISMA guidelines, to analyze the anatomy, morphological variations, and clinical implications of the TVI. The findings demonstrated that the TVI is present in up to 65% of imaging studies and 100% of cadaveric dissections, with four distinct morphological patterns. The muscle plays an important role in patellar stabilization and knee biomechanics, and has close relationships with neurovascular structures, which has direct implications for orthopedic surgery and rehabilitation. Recognizing the TVI is essential for clinical practice, especially in orthopedic procedures, imaging interpretation, and anatomical education, contributing to surgical safety and improved functional outcomes.