Table 3.

Potential Advantages, Disadvantages, and Complications of Quadriceps Tendon Autograft Use

Advantages

Denser collagen matrix than patellar tendon autograft

Larger uniform graft diameter compared with hamstring or patellar tendon autograft

Often still available, even in revision setting

Harvest causes less morbidity (numbness, anterior knee pain, pain with kneeling) than patellar tendon autograft harvest

Autograft use potentially minimizes risk of rerupture in younger active patients compared with allograft use

Disadvantages

Technically demanding, more time-consuming technique

Longer scar compared with hamstring harvest if open technique is used

Complications

Quadriceps tendon rupture (rare)

Synovitis or cyclops formation around graft, limiting full extension

Over-tensioning graft with knee in flexion, limiting full extension

Quadriceps inhibition or delayed recruitment postoperatively