With firm tension on the sutures, the Arthrex Quadriceps Tendon Stripper/Cutter is used to strip, and then cut the graft proximally once the desired graft length is achieved. John W. Xerogeanes, MD, (Atlanta, GA) demonstrates a minimally invasive quadriceps tendon harvest for ACL reconstruction. When using the quad tendon graft harvester (Arthrex), the joint capsule can be penetrated if the tendon is cut with excessive force. 2 FiberLoop with FiberTag Tape (Arthrex; Fig 4). For all-inside ACL reconstructions, we prefer to harvest grafts 6.5 to 7 cm in length. This is measured with the Stripper/Cutter handle . After spreading the subcutaneous tissue, the distal quad is identified. (Arthrex) and the Quad Tendon Stripper/Cutter (Arthrex; Fig 3). We also describe the updated preparation of the quad tendon with FiberTag TightRope (Arthrex) and FiberTag ABS (Arthrex). Graft Preparation The graft is taken to the back table, and the ends are prepared using a SpeedWhip ripstop technique with No. The design of the blade limits the depth of the cut to 7 mm. The tourniquet is let down, and bleeding is controlled with electrocautery. The traction suture is then used to pass the tendon through a 10 mm double blade quad tendon cutter (Arthrex) (Fig 1C). In addition, maintaining an even depth of graft excision with the No. A quad tendon graft harvester (Arthrex, Naples, FL) is then used in a manner consistent with its technique guide (Fig 1A). 9 Centering the graft harvester just lateral to the midpoint of the patella ensures that the 9- to 10-mm-wide graft is obtained from the longest portion of the asymmetric quadriceps tendon. If a small harvest incision was utilized, a rotator cuff suture passer (Express Sew or Scorpion) can be utilized to more easily reach the proximal portions of the harvest site. Minimally invasive quadriceps tendon graft harvest is performed in similar fashion to the technique as described by Slone et al. The tendon may be cut either proximally to distally or the reverse. This is also referred to as a “cigar cutter.” The quad tendon cutter is used according to its technique guide.9 The tendon is tensioned manually using the traction suture, and 14 The ends of the graft are prepared using a SpeedWhip ripstop technique with No. 7 This autograft is harvested to a distance of 70 to 80 mm. We recommend the “push technique.” The blade is 2 FiberLoop with FiberTag Tape (Arthrex). The triple blade edges allow for either a “pull” or “push” cutting technique either from the point of transillumination to the proximal pole of the patella, or the reverse ().In general, we recommend a “push” technique. The Athrex (Naples, FL) quadriceps harvest knife is used for graft harvest. A knife is then used to lift the distal quad off the bone and a size 0 VICRYL is used to tag the quad tendon. Scorpion (Arthrex) device to close our proximal quad harvest. 15 blade and the quad tendon cutter (Arthrex) can be difficult, potentially resulting in areas of variable thickness of the graft. successfully harvest a partial-thickness graft. 4 An initial score of the quadriceps tendon is … The graft harvester (Arthrex) is this used to cut the graft proximally. A 9-mm cutting guide is seen running distal to proximal. Fig 3. The Arthrex quadriceps harvest knife is sharp on 3 sides and allows for either a “pull” or “push” technique for cutting the tendon. The distal portion of the tendon is then inserted through a quad tendon cutter (Arthrex).

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