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Author Topic: Info on ACLR using the quad tendon  (Read 932 times)

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Offline tez27

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Info on ACLR using the quad tendon
« on: March 15, 2011, 01:58:46 PM »
My friend had his ACLR yesterday and due to the fact that his hamstring was not in a good enough state to be used for the graft his surgeon has used his quadracep ligament, so just wondered if anyone else has had this and how they're recovery went etc, any info is appreciated as he knows nothing about using this ligament and what difference there is,and what to expect from it.
Thanks for reading and any info is appreciated
Take care Tez
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline Kaputt_Knee

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  • [Ed: Sue sadly passed away in 2016]
Re: Info on ACLR using the quad tendon
« Reply #1 on: March 15, 2011, 02:11:55 PM »
Hi Tez,

I think Clarky_Vl (Vicky) had one of her revisions done using the quad tendon. The rehab is not much different to be honest, just you have to treat the harvest site more carefully as the quad is such a powerful muscle. The quad tendon is the name given to the tendon above the knee cap, so maybe he got an "upper patella tendon" graft? Do you know if they used any bone plugs?

As for the hamstring tendon not being "good enough" - it is often read as being that the surgeon (or whoever harvested the graft), made a mess of the harvesting and did not get enough to be used. My first ACL recon on my left knee was supposed to be a hamstring one, but he switched after harvesting to a patella tendon graft, claiming my hamstrings were no good. 2.5 years later my new surgeon was able to harvest using the same access wound (scar) and later told me that I had excellent hamstring tendons. The second harvest was from the same tendons - semitendinosis and gracilias.


How's your knee bearing up?

Sue  ;)
 
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline tez27

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Re: Info on ACLR using the quad tendon
« Reply #2 on: March 15, 2011, 03:04:10 PM »
Sue thanks for the info I'm not sure if they used bone plugs or not I will check with him, I think the surgeon said that his hamstring was not in great shape possible because he used to be a pro footballer and has had a few different knee ops though maybe your right and it could be the fact that the doc made a mess of the harvest, though I dont want to think about that at the moment as its the same OS I am seeing because I am having some more problems with the knee, not anything to do with the ACL that seems to be strong but the doc thinks there could be a meniscus tear and something about the patella being very tight and he was talking about doing a lateral release, waiting for an appointment for a MRI at the moment so we will see what shows up on that, anyway thanks for the input, I will check on Vickys thread to see what I can find out from her.
I hope all is well with you and you have had a good season on the slopes take care Tez
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision

Offline Kaputt_Knee

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Re: Info on ACLR using the quad tendon
« Reply #3 on: March 15, 2011, 04:06:05 PM »
Tez, the skiing has been OK - mega in January, then I got Swine Flu which buggered up the beginning of February. I'm just back from 3 weeks in South Africa where I was paragliding in different locations in the sun and temperatures up to 45/47C with perfect cloudless clear blue skies and sunshine.. Some how I can't summon up much enthusiasm for skiing right now as it is just boilerplate or a slushfest, neither of which are particularly knee-friendly.  >:( Might be different if we get a good dump of snow, like the Cairngorms or Glencoe just received. Scotland has got three ski centres in the top 10 of where the best snow is in Europe right now.

As for the meniscus tear - yep been there done that. I'm currently nursing a suspected tear hoping to get through to the end of the season before going under the knife again. But unlike you I'm not standing at work all day - my job is riding a desk these days, so back ache and neck ache from working at the computer for 10 hours are more my problems. I only notice the meniscus when I try and pivot instead of walking around things  :(

Don't count on the MRI finding/identifying the tear though - they are only as good as the machine, the operator and the radiologist interpretting the the piccies in the end. There are some seriously duff machines and radiologists out there you know  ;)

Sue  ;D
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline emergRN

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Re: Info on ACLR using the quad tendon
« Reply #4 on: March 15, 2011, 04:33:48 PM »
Tez..I can't offer any info.  I just wanted to say that I hope your friend is doing OK.  We know what this all feels like, but I guess he has two harvest sites to deal with.  Poor Tez friend.

W
Rt.knee scope-1990-91Dx with Partial ACL tear
Rt. ACLr with hamstring graft-2010
Rt. knee scope- partial lateral menisectomy and plica excision 2010
ACL revision quad tendon graft- 2011 
Rt. Knee partial lateral menisectomy, debridement 2012
Rt. knee partial lateral menisectiomy, debridement 2014

Offline Snowy

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Re: Info on ACLR using the quad tendon
« Reply #5 on: March 16, 2011, 02:15:27 AM »
There's a brief comparative overview of the different graft types here that includes the quad tendon:

http://www.isakos.com/innovations/graftchoice.aspx

And a detailed study into quad tendon autografts:

http://findarticles.com/p/articles/mi_6806/is_2_66/ai_n31181530/

There are lots of other studies out there, but most of them are only accessible through medical databases. Googling just brings up a lot of abstracts, although these can also be helpful because they usually summarize the key findings of the study.

Vicky did have a quad tendon graft for one of her revisions, so she would be a good person to touch base with to find out about the experience of using this graft.

Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline tez27

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Re: Info on ACLR using the quad tendon
« Reply #6 on: March 16, 2011, 09:32:44 PM »
Thanks everyon for the info etc, I am just in from visiting my friend ad the poor guy is still in hospital because he has some kind of vertigo dizzy thing going on and his surgeon wont let him go home untill that gets sorted as he is worried about him having a fall and damaging the good work that has been done on his knee, from what he told me tonight the OS said that when he tried to harvest the hamstring he discovered that it was basically mush so he had to take the graft from somewhere else and decided the quad tendon was a stronger option than the pattela tendon and would give him a better result. and as far as my friend can tell the knee feels pretty good but as he gets really dizzy whenever he tries to get up and walk around so he hasen't really tested it much
the one good thing that has come of this is he cant sleep very well with the noise etc in the hospital so I have someone to have a good old tx conversation during the night when I cant sleep :D
Thanks again for all the info I appreciate it as does my friend.
Take care Tez
L K injured 25th June 2008
scope Jan 5th 10
diagnosis ACL rupture
fiberous band excised from acl
ACLr July 19th 2010  scope on 24th Sept 2011
ACL has failed incorrect tunnel placement
23rd July 2012 1st stage of a 2 stage ACL revision
10th May 2013 2nd stage ACL revision















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