ACL reconstruction using quadriceps tendon.

Arthroscopic anterior cruciate ligament (ACL) reconstruction is one of the most commonly performed1 and most successful procedures in sports medicine. Various autograft choices have been used for ACL reconstruction,2 and the results in terms of stability and return to sports activities have been good.3 The ideal autograft should have optimal mechanical properties and low donor-site morbidity. The most recurring graft choices are the bone-patellar tendon-bone (BPTB)4 and the semitendinosus/gracilis tendon.5 Unfortunately, BPTB autograft has been extensively associated with persistent donor-site morbidity, such as tenderness, anterior knee pain, pain on kneeling, infrapatellar contracture syndrome, patellar tendon rupture, and fat pad herniation. Of patients who have undergone arthroscopic ACL reconstruction using BPTB autograft, 40%60% have one or more of the described complications.1,6-9 Hamstring autograft donor-site morbidity includes ACL agonist weakness and disruption of the protective ACL proprioceptive arc.9,10 The quadriceps tendon graft has several potential advantages over BPTB and has recently gained attention as a promising option for primary and revision ACL reconstruction.2,11-13