Minimally Invasive Quad Harvest Featuring Endoscopic Closure and Preparation With Adjustable Suspensory Fixation Device Incorporated With Braided Suture

Abstract

The quad tendon has increasingly became a very common option for anterior cruciate ligament reconstruction. Minimally invasive approaches are one of the many advantages to the quad tendon graft. One of the issues with a small incision is assuring appropriate proximal closure. In this technique, we use the arthroscope to view proximally and a Scorpion (Arthrex) device to close our proximal quad harvest. We also describe the updated preparation of the quad tendon with FiberTag TightRope (Arthrex) and FiberTag ABS (Arthrex). These implants have FiberTag incorporated to the suspensory devices that creates a stable construct that is faster to incorporate into the quad with the slotted clamp. Together, these updates to the preparation and harvest should make the construct more reproducible and decrease donorsite morbidity respectively.

Anterior Cruciate Ligament Reconstruction Using a Fascia Lata Graft With FiberTape Augmentation

“…To avoid such an outcome, we recommend minimally invasive fascial closure according to Lavender et al. 23 It should also be mentioned that harvesting and dissection of the fascia lata from the vastus lateralis muscle can be difficult if the tourniquet is inflated.…”

Minimally Invasive Anterior Cruciate Ligament With Quadriceps Tendon Graft: A Proximal-to-Distal Harvest Technique

“…13 We currently perform a closure of the defect through an endoscopic technique described by Lavender et al. 14 The overlying skin and subcutaneous tissue are closed with absorbable suture.

Fig 4 In a superior view with the knee flexed at 90°, retractors are placed proximal and distal to visualize the RF tendon from the incision site.

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Technique for Harvest of Superficial Quadriceps Tendon Autograft

“… 5 The fixation of a short full-thickness QT (6-8 cm) into the tunnel requires special implants. 5 , 6 Therefore the idea of using a long superficial QT graft may offer the surgeon an option that is both more feasible and more capable of gaining full benefits of QT autograft.…”