Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep 15;9(10):e1459-e1465.
doi: 10.1016/j.eats.2020.06.006. eCollection 2020 Oct.

Open Full-Thickness Quadriceps Tendon Autograft Harvest With Repair for Anterior Cruciate Ligament Reconstruction

Alexandra H Aitchison  1 , Lindsay M Schlichte  1 , Daniel W Green  1 , Frank A Cordasco  2
Affiliations

Open Full-Thickness Quadriceps Tendon Autograft Harvest With Repair for Anterior Cruciate Ligament Reconstruction

Alexandra H Aitchison et al. Arthrosc Tech. .

Abstract

Historically, one of the most common graft choices for anterior cruciate ligament (ACL) reconstruction in the pediatric population has been the hamstring autograft. Although pediatric ACL reconstructions with a hamstring autograft have allowed a majority of children and adolescents to return to athletics, it has been reported that anywhere between 6% and 38% of these patients will go on to experience subsequent graft rupture. The quadriceps tendon autograft is an alternative to the hamstring tendon autograft that demonstrates superior preliminary outcomes, and we currently recommend it for skeletally immature patients undergoing primary and revision ACL reconstruction. This paper aims to describe our technique for an open full-thickness quadriceps tendon harvest with repair.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Lateral view of the right knee. A 5-cm incision is shown over the quadriceps tendon extending to the superior pole of the patella.
Fig 2
Fig 2
Right knee. Central portion of the quadriceps tendon marked with a surgical pen to the superior pole of the patella.
Fig 3
Fig 3
Right knee. Double-bladed scalpel is used to incise the central portion of the quadriceps tendon straddling the previously placed markings.
Fig 4
Fig 4
Right knee. The quadriceps tendon is freed from remaining surrounding tissue attachments with a #15 blade.
Fig 5
Fig 5
Right knee. Once proper length is obtained, the proximal end of the graft is amputated with a #15 blade.
Fig 6
Fig 6
Harvested 73-mm quadriceps tendon autograft for use in complete transphyseal anterior cruciate ligament reconstruction.
Fig 7
Fig 7
Right knee. View of the quadriceps tendon defect after completion of full-thickness graft harvest.
Fig 8
Fig 8
Right knee. Repair of the remaining quadriceps defect using #2 ETHIBOND sutures in an interrupted simple fashion.
Fig 9
Fig 9
Lateral view of the right knee. Finished quadriceps tendon repair extending to the superior pole of the patella.
Fig 10
Fig 10
Quadriceps tendon autograft prepared with a modified Krakow technique and BTB TightRopes on both the femoral and tibial ends.
Fig 11
Fig 11
One-year postoperative sagittal magnetic resonance imaging of the right knee after all epiphyseal anterior cruciate ligament reconstruction with a quadriceps tendon autograft (white circle).
See this image and copyright information in PMC

References

    1. Tepolt F.A., Feldman L., Kocher M.S. Trends in pediatric ACL reconstruction from the PHIS database. J Pediatr Orthop. 2018;38:e490–e494. - PubMed
    1. Dodwell E.R., LaMont L.E., Green D.W., Pan T.J., Marx R.G., Lyman S. 20 Years of pediatric anterior cruciate ligament reconstruction in New York State. Am J Sports Med. 2014;42(3):675–680. - PubMed
    1. Popkin C.A., Wright M.L., Pennock A.T. Trends in management and complications of anterior cruciate ligament injuries in pediatric patients. J Pediatr Orthop. 2018;38:e61–e65. - PubMed
    1. Cordasco F.A., Black S.R., Price M. Return to sport and reoperation rates in patients under the age of 20 after primary anterior cruciate ligament reconstruction: Risk profile comparing 3 patient groups predicated upon skeletal age. Am J Sports Med. 2019;47:628–639. - PubMed
    1. Larson C.M., Heikes C.S., Ellingson C.I. Allograft and autograft transphyseal anterior cruciate ligament reconstruction in skeletally immature patients: Outcomes and complications. Arthroscopy. 2016;32:860–867. - PubMed

LinkOut - more resources