The following is a technique demonstration for a minimally invasive harvest of a quadriceps tendon autograph for ACL reconstruction. You can see here I start with the knee flexed at 90 degrees, I make a 2.5 centimeter incision in the midline. You can go transverse for better cosmesis, but I like the longitudinal incision because it's easier for me to close the quadriceps tendon defect, which I do in all cases. Come through the subtense tissue, and then you'll see the quadriceps tendon right there superficially. I utilize, in this case, a double knife blade. The width is between 9 and 11 millimeters, depending on the size of the patient. I extend from the superior pole, make railroad tracks up, usually a distance of 65 millimeters for an on-side graft. Then I release the graft sharply off the superior pole of the patella. I prefer full thickness, as I'm showing here, but you certainly can go partial thickness if you like. I pass a stay suture to help mobilization of the tendon off the superior pole. Then I utilize that stay suture to pass through what we call a cigar cutter device to amputate the graft approximately, which you'll see here shortly. Here's the device going over the graft, and then squeeze the handle, and out comes the graft. Then I close my defect in the quadriceps tendon with interrupted number one vicral horizontal mattress sutures, usually five, for a complete closure of the tendon, as you see here, and then close the skin, and the graft is prepared on the back table. Thank you.

minimally invasive

quadriceps tendon autograft

ACL reconstruction

surgical technique

tendon harvesting

graft preparation