WHEN IS THE quadriceps tendon USED?
Age and level of physical activity of patients suffering from anterior cruciate ligament tears, are two primary factors that are taken into account by the orthopedist, not only for determining the type of treatment that is necessary (conservative or surgical), but also for choosing the right type of autograft to use during surgery.
The anterior cruciate ligament consists of two anatomic bundles, the anteromedial and the posterolateral, which serve different functions in knee movement. By the end of the 1990s, as a type of autograft that is transplanted from one part of the body to another, the quadriceps tendon qualifies for the reconstruction of the two bundles.

WHAT ARE THE ADVANTAGES AND DISADVANTAGES?
Despite the fact that many knee surgeons opt for quadriceps tendon grafts, a study published by Arthroscopy Techniques in 2014 indicates that this type of graft has never gained universal acceptance. Nevertheless, quadriceps tendon grafts are versatile grafts that are characterized by high tear resistance, and the ability to be harvested in different lengths, widths and thicknesses according to the patient’s needs (and subsequently reconstruct a double-bundle tendon), as well as the option to be harvested with or without bone block from the knee cap.
The same study emphasizes the reason why this type of graft is generally not preferred. The quadriceps tendon graft is harvested by an open technique, requiring a 6 to 8 cm longitudinal incision, often leading to extensive scarring postoperatively, as well as a prolonged operative duration and the bone integration of the graft to the tibia or femur not facilitated. Currently, there are new minimally invasive approaches in which the quadriceps tendon graft can be used without a bone block and can be harvested through an incision that doesn’t exceed 2,5-3 cm.
In 2012, another study published by Musculoskeletal Disorders was based on excellent clinical outcomes particularly in athletes practicing judo, wrestling, and football, as well as patients suffering from medial collateral ligament tears, who chose a quadriceps tendon graft along with a 2 cm bone block. 

WHAT HAPPENS AFTER SURGERY?
Like any other anterior cruciate ligament reconstruction, and in order to avoid damaging the graft, return to athletic activities depends on the orthopedist and is estimated to be between 6 to 9 months