As quadriceps tendon autograft harvest becomes increasingly popular as a choice for ACL reconstruction, its ... read more ↘ harvesting technique is also evolving.
Useful implements and steps I have found for the harvest:
1. A narrow (pediatric) speculum, taken apart, using the half that has the handle on it: this helps with narrow/deep retraction with its reach but also its dome-shaped protrusion that keeps soft tissue away from the quad tendon for excellent visualization, direct or scope-aided
2. Use the scope to find the course of the quadriceps tendon, and mark on skin its proximal location, so that I can aim the harvester in-line with the tendon.
3. Use a harvester such as #QuadPro by #Arthrex that has calibrated clear tubing to determine harvest depth at all times, and cutting push rod to cut the graft deep within the exposure without having to enlarge the incision just to do that.
4. Use a rotator cuff self-retrieving suture passer (Scorpion by Arthrex) to close the quadriceps tendon defect through a minimal incision.
With these steps, quadriceps tendon autograft harvest is smooth, safe, and minimally invasive, all of which can lead to improved graft quality and consistency, decreased patient discomfort, decreased OR time, and improved patient satisfaction. ↖ read less
