Quadriceps tendon graft

A portion of the tendon above the kneecap is harvested, with or without a bone plug. Its thickness allows for a graft with a significant diameter.

The harvesting technique and fixation vary depending on the surgeon.

It can be used as a first-line option or in revision, especially when other sites have already been harvested.

Contemporary data are encouraging, but the experience is historically less extensive than for some other grafts.

The harvest may accentuate inhibition and knee extension deficits in the early phase. Loading must progress without ignoring pain and swelling.

Pain when kneeling generally seems less pronounced than with the patellar tendon, without being impossible.

Early recovery of extension is planned with the physical therapist and the surgeon, especially if the quadriceps is very inhibited. This is not an invitation to force it through sharp pain.

Ask how expected stiffness, a normal response to loading, and a loss of extension that justifies an opinion will be distinguished.

• Compare extension with the other side.
• Report any regression in extension quickly.

The quadriceps helps absorb and produce force around the knee. Its inhibition is frequent after any trauma or surgery; a quadriceps harvest makes this subject particularly visible. An early difficulty locking the knee or fatigue in the thigh does not predetermine the final outcome, but justifies careful monitoring of mobility and response to loading.

Ask if the harvest includes a bone plug, what type of fixation is planned, and how the team monitors extension. Mention any previous quadriceps surgery, supra-patellar pain, or professional requirements for repeated climbing.

These markers are used to prepare a clinical exchange and to understand the possible choices. They do not allow for a remote conclusion on a lesion, a treatment, or a schedule: the context, the examination, and any associated procedures remain decisive.

To delve deeper into "Quadriceps tendon graft", take elements from the sections "An adaptable graft" and "When is it discussed?" with your own timeline. It is useful to separate what is certain — date of trauma, report, triggering activity — from what remains an impression, such as the feeling of weakness or giving way. This distinction makes the information easier for the team to interpret.

The cited publications describe populations and trends; they do not replace the instructions of the team that knows the file. During the consultation, ask how general information applies or does not apply to your situation, what its limitations are, and what sign would justify contacting them again before the scheduled follow-up.

After the discussion, note the next step, the person to contact, and the symptoms to watch for. If a response seems contradictory to a report or written instruction, ask for clarification rather than changing weight-bearing, activities, or medications on your own.

• Aspetar 2023. Clinical Practice Guideline on Rehabilitation after ACL reconstruction.
• AAOS 2022. Management of Anterior Cruciate Ligament Injuries — Clinical Practice Guideline.
• BJSM 2022. OPTIKNEE consensus recommendations to optimise knee health after traumatic knee injury.
• Belk 2018. Quadriceps tendon autograft for primary ACL reconstruction: systematic review.