AN ALTERNATIVE CRUCIATE RECONSTRUCTION GRAFT - THE CENTRAL QUADRICEPSTENDON

The central quadriceps tendon, above the patella, is thicker and wider than the patella tendon. Using precise technique, one can obtain a te ndon graft for cruciate reconstruction with 50% greater mass than a pa tellar tendon bone-tendon-bone graft of similar width. The central qua driceps tendon graft may be harvested by a second surgeon while the fi rst surgeon is simultaneously accomplishing notchplasty and tunnel pla cement for cruciate ligament reconstruction. Consequently, this crucia te ligament reconstruction graft offers time savings as well as greate r, tendon volume. The central quadriceps tendon graft is difficult to harvest, with significant risk of entering the suprapatellar pouch and losing knee distension during ACL reconstruction. By careful adherenc e to the technique described in this article, the surgeon can obtain t his reconstruction graft safely, It is important to recognize the anat omic subtleties of the proximal patella, which include a curved proxim al surface, dense cortical bone, and closely adherent suprapatellar po uch. Proper technique is of utmost importance in obtaining this tendon graft safely and efficiently.