Technical considerations for quadriceps tendon harvest

Abstract

Despite numerous studies in the orthopedic literature, controversy exists with regard to graft options for anterior cruciate ligament (ACL) reconstruction. Quadriceps tendon (QT) is a relatively infrequently used graft for primary ACL reconstruction, although interest in the graft seems to be increasing. Multiple studies have demonstrated excellent clinical outcomes and low donor site morbidity with autologous QT grafts, in addition to favorable biomechanical and histological properties. The QT autograft is quite versatile and can be used with the most reconstructive techniques, in the primary or revision setting. Recently developed minimally invasive harvest techniques and specialized instrumentation allow for a reproducible, quick, and easy harvest through a small cosmetic incision. In this chapter, we will review the anatomy and preoperative considerations, describe a minimally invasive harvest of the soft tissue QT graft and patellar bone block QT graft, and comment on rehabilitation and complications.