Summary

A cadaveric study focused on minimally invasive quadriceps autograft harvesting to maximize the length and diameter of the graft for ACL reconstruction.

Abstract

Background

Anterior cruciate ligament (ACL) injuries often require reconstruction using grafts such as bone-patellar-tendon-bone (BPTB), hamstring (HT), and quadriceps (QT). While the QT graft is strong, traditional harvesting methods can cause significant donor site morbidity. By using a conventional graft tendon stripper, the procedure aims to obtain the full length of tendon fibers necessary for anterior cruciate ligament (ACL) reconstruction. The aim of this study was to determine if this technique can produce grafts of sufficient length and diameter.

Purpose

To evaluate the feasibility and effectiveness of a minimally invasive technique for harvesting the superficial band of the quadriceps tendon for ACL reconstruction.

Methods

From September to October 2023, we conducted a study using full-body Thiel-embalmed cadavers over 18 years of age without pathology-related alterations in lower limb anatomy. The mid-diameter of the graft was measured at its midpoint, and the peripheral diameter was taken at the ends. The length of the triple-folded graft was measured from end to end. A digital vernier caliper measured the length and mid-diameter, and a graft sizer measured the peripheral diameter.

Results

Sixteen quadriceps tendon autografts were harvested from 16 knees of 8 cadavers (mean age: 64.7 ± 9.9 years). The minimally invasive harvesting technique yielded a mean graft length of 289.0 ± 10.3 mm before folding, a mean mid-diameter of 9.7 ± 0.7 mm, a mean peripheral diameter of 8.5 ± 0.4 mm, and a mean length of 93.1 ± 4.7 mm after triple folding.

Conclusion

Minimally invasive harvesting of the superficial band of the quadriceps tendon is feasible for ACL reconstruction, providing adequate graft dimensions. Further clinical studies are recommended.