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Related Experiment Video

Updated: Feb 6, 2026

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Predicted quadriceps vs. quadrupled hamstring tendon graft size using 3-dimensional MRI.

William B Ashford1, Thomas H Kelly2, Russell W Chapin3

  • 1Department of Orthopaedic Surgery, MUSC, 96 Jonathan Lucas St, CSB 708, Charleston, SC 29425, United States.

The Knee
|August 29, 2018
PubMed
Summary

Quadriceps tendon grafts show a positive correlation with hamstring grafts and are a viable alternative for ACL reconstruction. This study found quadriceps tendon grafts to be a sufficient size in all patients, even when hamstring grafts were predicted to be too small.

Keywords:
ACL reconstructionAutograftHamstring graftQuadriceps graft

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Radiology

Background:

  • Anterior Cruciate Ligament (ACL) reconstruction often utilizes autografts.
  • Hamstring autografts are commonly used but may be insufficient in size for some patients.
  • Quadriceps tendon autografts present a potential alternative graft source.

Purpose of the Study:

  • Compare predicted graft size (cross-sectional area and diameter) between quadriceps tendon and quadrupled hamstring autografts.
  • Evaluate the suitability of quadriceps tendon grafts in patients with inadequate hamstring graft dimensions for ACL reconstruction.

Main Methods:

  • Retrospective analysis of 54 knee 3D MRIs.
  • Defined quadriceps tendon graft area (1 cm wide, 3 cm superior to patella).
  • Defined quadrupled hamstring graft area (double gracilis/semitendinosus, 3 cm superior to joint line).
  • Utilized Pearson correlation to compare graft sizes.

Main Results:

  • Mean graft areas: Quadriceps tendon (84.4 mm²) vs. Hamstring (47.2 mm²).
  • Significant positive correlation found between quadriceps tendon and hamstring graft sizes (r=0.41, p=0.002).
  • Nine patients (17%) had insufficient predicted hamstring graft diameter (<8 mm), all had sufficient quadriceps tendon graft diameter (>8 mm).

Conclusions:

  • A positive correlation exists between predicted quadriceps tendon and quadrupled hamstring graft sizes.
  • Quadriceps tendon grafts are a viable alternative, especially in patients at risk for insufficient hamstring grafts.
  • All assessed patients demonstrated adequate predicted quadriceps tendon graft size for ACL reconstruction.