Skip to main content

ACL Reconstruction Using a Flat Quadriceps Tendon Graft Without Bone Block

  • Chapter
  • First Online:
ESSKA Instructional Course Lecture Book

Abstract

Many surgeons use quadriceps tendon (QT) graft for anterior cruciate ligament (ACL) revision surgery; however, despite excellent clinical results, the QT has not achieved universal acceptance for primary ACL reconstruction. One of the reasons for this may be that the QT is technically demanding to harvest, and the scar from open harvesting techniques is less cosmetically favorable than that from hamstring tendon techniques. Recent evidence has suggested that broad flat QT soft tissue grafts may more closely mimic native ACL “ribbon-like” morphology than hamstring tendon grafts.

Instrumentation for minimally invasive QT harvesting has also reduced technical difficulty of QT harvesting and improved cosmetic results. Hence, technical and cosmetic concerns are no longer barriers to QT use. These anatomic and biomechanical advantages and technical developments make the QT an increasingly attractive option for both primary and revision ACL reconstruction. Furthermore, using the QT as a soft tissue graft eliminates the risk for patellar fracture and reduces harvest site morbidity.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Chen CH, Chuang TY, Wang KC, Chen WJ, Shih CH. Arthroscopic anterior cruciate ligament reconstruction with quadriceps tendon autograft: clinical outcome in 4–7 years. Knee Surg Sports Traumatol Arthrosc. 2006;14(11):1077–85.

    Article  CAS  Google Scholar 

  2. Geib TM, Shelton WR, Phelps RA, Clark L. Anterior cruciate ligament reconstruction using quadriceps tendon autograft: intermediate-term outcome. Arthroscopy. 2009;25(12):1408–14.

    Article  Google Scholar 

  3. Slone HS, Romine SE, Premkumar A, Xerogeanes JW. Quadriceps tendon autograft for anterior cruciate ligament reconstruction: a comprehensive review of current literature and systematic review of clinical results. Arthroscopy. 2015;31(3):541–54.

    Article  Google Scholar 

  4. Lund B, Nielsen T, Fauno P, Christiansen SE, Lind M. Is quadriceps tendon a better graft choice than patellar tendon? A prospective randomized study. Arthroscopy. 2014;30(5):593–8.

    Article  Google Scholar 

  5. Hoeher J, Balke M, Albers M. Anterior cruciate ligament (ACL) reconstruction using a quadriceps tendon autograft and press-fit fixation has equivalent results compared to a standard technique using semitendinosus graft: a prospective matched-pair analysis after 1 year. Knee Surg Sports Traumatol Arthrosc. 2012;20:147.

    Article  Google Scholar 

  6. Stäubli HU, Schatzmann L, Brunner P, Rincon L, Nolte LP. Mechanical tensile properties of the quadriceps tendon and patellar ligament in young adults. Am J Sports Med. 1999;27(1):27–34.

    Article  Google Scholar 

  7. Fink C, Herbort M, Abermann E, Hoser C. Minimally invasive harvest of a quadriceps tendon graft with or without a bone block. Arthrosc Tech. 2014;3(4):e509–13.

    Article  Google Scholar 

  8. Fink C, Hoser C. Einzelbündeltechnik: quadrizepssehne in portaltechnik. Arthroskopie. 2013;26(1):35–41.

    Article  Google Scholar 

  9. Fink C, Lawton R, Förschner F, Gföller P, Herbort M, Hoser C. Minimally invasive quadriceps tendon single-bundle, arthroscopic, anatomic anterior cruciate ligament reconstruction with rectangular bone tunnels. Arthrosc Tech. 2018;24(7):e1045–56.

    Article  Google Scholar 

  10. Shino K, Nakata K, Nakamura N, Toritsuka Y, Horibe S, Nakagawa S, Suzuki T. Rectangular tunnel double-bundle anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft to mimic natural fiber arrangement. Arthroscopy. 2008;24(10):1178–83.

    Article  Google Scholar 

  11. Herbort M, Tecklenburg K, Zantop T, Raschke MJ, Hoser C, Schulze M, Petersen W, Fink C. Single-bundle anterior cruciate ligament reconstruction: a biomechanical cadaveric study of a rectangular quadriceps and bone—patellar tendon—bone graft configuration versus a round hamstring graft. Arthroscopy. 2013;29(12):1981–90.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christian Fink .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 ESSKA

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Fink, C., Abermann, E., Smigielski, R., Siebold, R., Herbort, M. (2020). ACL Reconstruction Using a Flat Quadriceps Tendon Graft Without Bone Block. In: Hirschmann, M., Kon, E., Samuelsson, K., Denti, M., Dejour, D. (eds) ESSKA Instructional Course Lecture Book . Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61264-4_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-61264-4_12

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-61263-7

  • Online ISBN: 978-3-662-61264-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics