Banff Sport Medicine Foundation
  • About
    • Meet the Team
    • Our Partners
    • Annual Reports
  • Research
    • BPII
    • Current Research Projects
    • Research Publications
  • Education & Training
    • Orthopaedic Fellowship
    • Injury Prevention
    • Patient Education
  • Health Library
  • News & Views
  • Connect
    • Patient Stories
    • Ways to Support
    • Newsletter Sign-up
  • DONATE
  • About
    • Meet the Team
    • Our Partners
    • Annual Reports
  • Research
    • BPII
    • Current Research Projects
    • Research Publications
  • Education & Training
    • Orthopaedic Fellowship
    • Injury Prevention
    • Patient Education
  • Health Library
  • News & Views
  • Connect
    • Patient Stories
    • Ways to Support
    • Newsletter Sign-up
  • DONATE
June 7, 2020 In Education, Health Library

Quadriceps Tendon Autograft

adventure-cold-country-358046 1000×669

The quadriceps tendon autograft is the third type of autograft used for anterior cruciate ligament (ACL) reconstruction.

—– Learn more about the other graft types here —–

Although the use of this graft was first described in 1979, it has not been widely used until more recently.  The most recent surveys show that worldwide, this graft is used about 10% of the time (2014) but <1% of the time in the US and Canada (2017). 

It involves harvesting a 9-11 mm diameter graft from the central portion of the quadriceps tendon just above the patella (kneecap).  It can be harvested with a bone block from the patella (shown as “Quad-Patella Bone” in the diagram below), or simply taken as a soft tissue graft as the tendon is long enough to be used alone.  Like the patellar tendon, the quadriceps tendon has the potential to fully regenerate after harvest.


Advantages of the quadriceps tendon autograft

One of the main advantages of this graft is that the quadriceps tendon is large enough to provide consistency and predictability with regard to graft size, even in the small female. 

It has a larger cross-sectional area than a patellar tendon graft and is also biomechanically superior in terms of strength and stiffness.  Most studies show that there is significantly less anterior knee pain and kneeling pain than after ACL reconstruction with patellar tendon, as well as less impairment of quadriceps muscle strength recovery. 

It also has a low incidence of skin numbness (<5%) and is a good autograft option to consider when performing a revision (re-do) surgery for a torn ACL graft because of its large size. 


Disadvantages of the quadriceps tendon autograft

One of the main disadvantages of this graft is that it is more difficult to harvest for surgeons who have not had much experience with it.  Most surgeons are more proficient in using hamstring or patellar tendon autographs, so they may have less success with the quadriceps tendon graft.

However, studies comparing quadriceps tendon autograft to hamstring tendon autograft and patellar tendon autograft, performed by surgeons who routinely use this graft, consistently show no significant difference in outcomes.  

Another disadvantage is that there is the potential for a fracture of the patella to occur if a bone block is included in the graft.  One case series by an experienced surgeon showed a patellar fracture rate of 8%, although it is important to note that only one of those patients had an unacceptable outcome.  Moreover, including a bone block from the patella is seen as an advantage in terms of faster graft healing by some surgeons. 

A minor disadvantage is that the incision can be quite long (similar to patellar tendon harvest incision), although the recent development of newer surgical tools allows for a much shorter incision. 


Contributing expert

Dr Greg Buchko, Orthopaedic Surgeon

Tweet
Share
Pin
Share
0 Shares
ACL ACL graft ACL reconstruction

Related Articles

  • road race pexels-photo-248547 1000×666
    Return to Sport after ACL injury: ACL experts develop a consensus
  • action-bicycle-bike-2924491
    Phases of your Banff Sport Medicine Postoperative Rehabilitation Program after ACL Reconstruction

Share this page

Tweet
Share
Pin
Share
0 Shares

Advantages
• Can be used in smaller sized females
• Stronger than patellar tendon graft
• Less anterior knee pain and pain when kneeling
• Less impairment of quadriceps muscle strength recovery

Disadvantages
• Harder to carry out in less experienced surgeons
• Potential fracture to the patella (kneecap)
• Long incision

Recent Posts

  • Mastering Aging and the musculoskeletal system
  • Educational Opportunities at BSMF
  • Mastering Aging: the Cardiovascular System
  • #Knees4Skis: On Hill Warm Up
  • #Knees4Skis: 8 Essential Exercises to Help reduce Knee Injury
Banff Sport Medicine white logo

The Banff Sport Medicine Foundation is a registered charity with a Mission to “Prevent, treat, rehabilitate, and research musculoskeletal and sport injuries among people of all ages and abilities.”

Add impact to your inbox

Sign up for our newsletter and get expert injury prevention tips, a sneak peek of our latest research, inspiring patient stories, and more, direct to your inbox.

Newsletter Sign-Up

News & Views

  • Mastering Aging and the musculoskeletal system January 20, 2021
  • Educational Opportunities at BSMF January 10, 2021
  • Mastering Aging: the Cardiovascular System January 10, 2021

Popular Posts

Does stretching improve performance or help with injury?Does stretching improve performance or help with injury?0 Total Shares
The importance of pre-surgery exercise: “Prehabilitation”The importance of pre-surgery exercise: “Prehabilitation”0 Total Shares

 

Charitable Registration #793737685RR0001

The Banff Sport Medicine Foundation respects the privacy of our supporters. We do not, under any circumstances, sell, trade, or release our Foundation mailing list or any part of the information we collect to any other party or agency.

Copyright © 2020 Banff Sport Medicine Foundation. All Rights Reserved

flowww uses Let's Encrypt SSL certificates