Optimizing ACL Reconstruction in 2022: A Case-Based Approach (AANA22)-Quad Tendon Soft Tissue ACL Graft Harvest

Video Transcription

Video Summary

The speaker, an experienced ACL surgeon with extensive quad tendon graft experience, discusses the anatomical considerations, harvesting techniques, fixation methods, and complications related to quad tendon grafts for ACL reconstruction. He emphasizes the predictability and strength of the quad tendon graft, its suitability for young and small patients, and the advantages over hamstring grafts, especially in terms of graft thickness and morbidity. The speaker details practical harvesting tips, including incision types, instrumentation (such as triple-bladed knives and tube harvesters), and the importance of graft length (6.5-7 cm). Fixation techniques like adjustable loop buttons and tape struts enhance graft security and reduce elongation risks. Morbidity is low, with minimal numbness or residual weakness compared to hamstrings. Complications such as hematomas and cyclops lesions are rare. He favors all-inside femoral tunnel drilling over trans-tibial for better anatomic placement. Overall, outcomes are positive, but further data will come in the next five years.

Asset Caption

John Xerogeanes, M.D.

Keywords

ACL reconstruction

quad tendon graft

harvesting techniques

fixation methods

graft morbidity

femoral tunnel drilling