Related Experiment Video
Updated: May 23, 2026
Harvesting of Peroneus Longus Tendon Autograft
Published on: September 2, 2025
Anatomic guidelines for harvesting a quadriceps free tendon autograft for anterior cruciate ligament reconstruction
Julienne Lippe1, Amy Armstrong, John P Fulkerson
1Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, Connecticut, USA.
Purpose:
The purpose of this study was to review the anatomy of the quadriceps tendon and provide guidelines for harvesting the quadriceps tendon for anterior cruciate ligament (ACL) reconstruction.
Methods:
Eleven cadaveric knees were dissected, and the quadriceps tendon was analyzed. Multiple measurements of length, depth, and width were taken in a standardized manner for each cadaver and recorded.
Results:
The quadriceps tendon superficial morphology showed 2 distinct peaks, with the maximum length correlating with the lateral peak. The mean tendon peak length was 88.3 ± 8.4 mm (range, 78.3 to 99.7 mm). The mean width of the quadriceps tendon at its insertion onto the patella was 43.3 ± 5.8 mm (range, 34.3 to 54.1 mm). The quadriceps tendon was noted to be asymmetric, with the maximum tendon length located at 61.6% ± 4.1% of the width from the medial border of the quadriceps tendon insertion. This point was also the maximum tendon depth at insertion.
Conclusions:
Quadriceps free tendon graft harvesting should begin by locating the apex (maximum length) of the quadriceps tendon (61% of the distance from the patella's medial edge). The surgeon should then harvest a 10-mm-wide graft centered about 2 mm medial to this point, using the depth of a No. 10 scalpel blade (7 mm) as a guide to thickness to harvest an optimal quadriceps free tendon graft for ACL reconstruction.
Clinical Relevance:
This anatomic study identifies the site of harvest of a quadriceps free tendon autograft (without a patellar bone block) to maximize the length and bulk of the graft for its use in ACL reconstruction.
