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
. 2024 Jun;144(6):2723-2730.
doi: 10.1007/s00402-024-05268-8. Epub 2024 May 16.

A novel surgical technique for revision anterior cruciate ligament reconstruction using an isolated rectus femoris tendon autograft

Thorsten Huber  1 , Marcel Frühwirth  2 , Florian Hartenbach  1 , Sarah Franzmair  1 , David Ullmann  1 , Björn Rath  1
Affiliations

A novel surgical technique for revision anterior cruciate ligament reconstruction using an isolated rectus femoris tendon autograft

Thorsten Huber et al. Arch Orthop Trauma Surg. 2024 Jun.

Abstract

Introduction: Only a few anatomic studies have described an isolated rectus femoris tendon autograft for anterior cruciate ligament (ACL) reconstruction. This study aims to demonstrate a new surgical technique utilising the rectus femoris tendon for ACL reconstruction. This study hypothesises that the rectus tendon autograft will yield satisfying postoperative outcomes in terms of stability, with minimal complications at the harvest site.

Methods: This retrospective study investigated the outcomes of 28 revision ACL reconstructions using a rectus tendon autograft with a mean follow-up of 41.7 (range, 24.0-64.8) months. A 3 cm longitudinal incision was used to harvest the rectus tendon with an open tendon stripper. Intraoperative collected data included the length of the tendon and thickness of a 4-fold graft. Further outcome parameters include anterior cruciate ligament stability and range of motion. Additionally, postoperative complications, especially donor site morbidity, were documented in type and frequency.

Results: The mean tendon length measured 32.4 cm (range, 30-35 cm). After preparing a 4-fold graft, the mean diameter was 9.2 mm (range, 8.0-10 mm) at the tibial and 9.0 mm (range, 7.5-10 mm) at the femoral end. Stability evaluated by the Lachman test improved significantly from 2 (Interquartile range (IQR), 2-3) preoperatively to 0 (IQR, 0-1) postoperatively (p < .001). Rerupture of the anterior cruciate ligament graft was observed in 2 patients (7.1%). Four patients showed a persistent extension deficit of about 5 degrees postoperatively. Two of them underwent revision surgery due to a Cyclops lesion. Only one patient complained of prolonged pain at the harvest site (3.6%).

Conclusion: The 4-fold rectus tendon represents a novel autograft technique in revision ACL reconstruction. This study provides evidence of appropriate graft dimensions and satisfying postoperative outcomes regarding stability. The technique is associated with a low complication rate at the harvest site.

Study design: Case series; Level of evidence, IV.

Keywords: ACL; Anterior cruciate ligament autograft; Rectus femoris tendon; Revision anterior cruciate ligament reconstruction.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Shichman I, Baruchi D, Rachevsky G et al (2023) Bone filling decreases donor site morbidity after anterior cruciate ligament reconstruction with bone–patellar tendon–bone autografts. Arch Orthop Trauma Surg 143:2565–2572. https://doi.org/10.1007/S00402-022-04572-5/METRICS - DOI - PubMed
    1. Sollberger VD, Korthaus A, Barg A, Pagenstert G (2023) Long-term results after anterior cruciate ligament reconstruction using patellar tendon versus hamstring tendon autograft with a minimum follow-up of 10 years—a systematic review. Arch Orthop Trauma Surg 143:4277–4289. https://doi.org/10.1007/S00402-022-04687-9/TABLES/11 - DOI - PubMed
    1. Katagiri H, Nakagawa Y, Miyatake K et al (2023) Comparison of clinical outcomes after Revision Anterior Cruciate Ligament Reconstruction using a bone-patellar Tendon-bone autograft and that using a double-bundle hamstring Tendon Autograft. J Knee Surg 36:613–621. https://doi.org/10.1055/S-0041-1740927 - DOI - PubMed
    1. Kunze KN, Moran J, Polce EM et al (2023) Lower donor site morbidity with hamstring and quadriceps tendon autograft compared with bone-patellar tendon-bone autograft after anterior cruciate ligament reconstruction: a systematic review and network meta-analysis of randomized controlled trials. Knee Surg Sports Traumatol Arthrosc 31:3339–3352. https://doi.org/10.1007/S00167-023-07402-2 - DOI - PubMed
    1. Diermeier T, Tisherman R, Hughes J et al (2020) Quadriceps tendon anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 28:2644–2656. https://doi.org/10.1007/S00167-020-05902-Z - DOI - PubMed

LinkOut - more resources