Quadriceps Tendon Autograft

History of Using Quadriceps Tendon Autograft in ACL Surgery

The quadriceps tendon is becoming a popular graft due to newer minimally invasive harvesting instruments and the invention of fixation implants that can easily fixate to the graft. Historically, the quadriceps tendon was a less chosen graft because it required a very long incision and fixation implants were suboptimal.

What are some advantages of quadriceps tendon grafts?

The quadriceps tendon has a greater length compared to the patellar tendon and it has a greater single-stranded thickness compared to quadriceps tendons. It does not come with bone on either side so it is a less painful harvest post-operatively. It is a robust graft in which the surgeon can choose both the length and diameter of the harvest. Emerging data suggest that these grafts have a very low re-rupture rate similar to hamstring and patellar tendon grafts.

What are some disadvantages of quadriceps tendon grafts?

The quadriceps tendon graft requires an additional incision above the kneecap. In a patient who is concerned about cosmetics, this incision will be an additional scar that tends to be more visible because it is above the kneecap.

The quadriceps tendon graft is usually 1 cm in diameter. On average the quadriceps tendon is 3 cm wide. Therefore, the harvest will take one-third of the native tendon. Theoretically, losing one-third of the quadriceps tendon could affect the function in a kicker or jumper.

See Dr. Chen’s Technique Videos on Quadriceps Tendon Harvesting

Minimally Invasive Quadriceps Tendon Harvesting Technique for ACL Graft