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Related Experiment Video

Updated: Jan 18, 2026

Harvesting of Peroneus Longus Tendon Autograft
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A Simple, Anatomical, and Reproducible Technique for Harvesting a Partial-Thickness Layered Rectangular Quadriceps

Yasukazu Yonetani1,2, Kazunori Shimomura3,4, Akira Tsujii4,5

  • 1Osaka Nakanoshima Orthopedic Clinic, Osaka, Japan.

Arthroscopy Techniques
|January 16, 2026
PubMed
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This study presents a layered quadriceps tendon-bone harvesting technique for anatomic anterior cruciate ligament reconstruction (ACLR). This method improves graft-tunnel fit and bone healing for better knee biomechanics.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanical Engineering

Background:

  • Anatomic anterior cruciate ligament reconstruction (ACLR) aims to restore native knee biomechanics by replicating the anterior cruciate ligament's (ACL) 3D structure.
  • Traditional round tunnels in ACLR may not fully replicate the ACL's fiber alignment, potentially impacting outcomes.
  • The quadriceps tendon-bone autograft is increasingly favored for ACLR due to its graft properties and reduced anterior knee pain.

Purpose of the Study:

  • To describe a novel layered quadriceps tendon-bone harvesting technique for anatomic ACLR.
  • To detail a method that preserves graft quality and replicates native ACL fiber orientation using rectangular tunnels.
  • To highlight the benefits and limitations of this specific ACLR technique.

Main Methods:

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  • A layered quadriceps tendon-bone harvesting technique is presented, preserving the third tendon layer.
  • A rectangular bone block is harvested, suitable for creating rectangular tunnels that mimic native ACL fiber alignment.
  • The technique relies on anatomical landmarks and minimal instrumentation for reproducibility.

Main Results:

  • The described technique facilitates anatomic ACLR with decreased graft-tunnel mismatch.
  • Potential benefits include reduced tunnel widening and enhanced bone-to-bone healing.
  • The method aims to provide a reproducible and high-quality graft for ACL reconstruction.

Conclusions:

  • This layered quadriceps tendon-bone harvesting technique offers a viable option for anatomic ACLR.
  • It addresses limitations of traditional techniques by improving graft-tunnel congruity and promoting bone healing.
  • While technically demanding, the approach can be effective with adequate surgical expertise.