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Arthroscopic reconstruction of the anterior cruciate ligament with autologous quadriceps tendon grafting

Published in N°268 - Book 2 - November 2017
Article viewed 24 times

Arthroscopic reconstruction of the anterior cruciate ligament with autologous quadriceps tendon grafting

By Victoria B. Duthon, Jacques Menetrey in category
Centre de Médecine du Sport et de l’Exercice - Hirslanden Clinique de la Colline 76b avenue de la Roseraie - 1205 Genève - tel : +41 22 702 25 41 email : [email protected]

Anterior cruciate ligament reconstructions are traditionally performed using an autologous graft of the hamstring and gracilis tendons or the patellar tendon (PT). The quadriceps tendon (QT) is usually used only for surgical revisions: just 11% of surgeons harvest it for a first intervention.

1. Introduction

Anterior cruciate ligament reconstructions are traditionally performed using an autologous graft of the hamstring and gracilis tendons or the patellar tendon (PT). The quadriceps tendon (QT) is usually used only for surgical revisions: just 11% of surgeons harvest it for a first intervention.1 But the advantage of this structure is that it can be taken with a bone block and the harvesting can be adjusted so that a graft of the desired size is obtained.2 It is also possible to harvest this tendon without a bone block. However, the harvesting does present some technical challenges since only a partial width and, more importantly, only a partial thickness of the quadriceps tendon is removed, so that it is not weakened. This article describes the technique for reconstruction of the anterior cruciate ligament using autologous quadriceps tendon grafting, which we have used on a daily basis for over 10 years.

 

2. Surgical technique

2.1 Patient set-up

Antibiotic prophylaxis with 1.5g IV cefuroxime 30 min before the intervention.

Patient positioned in dorsal decubitus with a mid-thigh tourniquet, une échelle and a lateral post positioning the knee in 90° of flexion.

The tourniquet is inflated at the start of the intervention.

2.2 Harvesting the graft

Skin marked at...

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