Central Quadriceps Tendon for Anterior Cruciate Ligament Reconstruction

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Abstract
We examined the anatomic and biomechanical adequacy of the central quadriceps tendon as an al ternative graft source for anterior cruciate ligament reconstruction. Morphometry was performed on 15 preserved and 6 fresh-frozen specimens. Biomechani cal testing was performed on the six fresh-frozen spec imens. We initially used a triple suture through the tendon construction, and then clamping directly on the tendon. Morphometry yielded the following meas urements: length, 6.1 ± 1.0 cm; width, 2.7 cm (range, 2.1 to 3.7); and thickness, 7 mm (range, 6.4 to 7.8). The thickness was 1.8 times that of the patellar tendon. Biomechanical testing showed that suture failure oc curred at 692 ± 181 N, and tendon failure occurred at 1075 ± 449 N. The load to tendon failure was 1.36 times that of a comparable-width patellar tendon graft, although the difference was not statistically significant. The failure mode was primarily through partial or com plete tendinous avulsion, with only one specimen fail ing at midsubstance. These findings show the central quadriceps graft is of sufficient size and strength to be used for anterior cruciate ligament reconstruction.