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Quadriceps tendon autograft is an effective alternative graft for posterior cruciate ligament reconstruction in isolated or multiligament injuries: a systematic review
  1. Austin McCadden1,
  2. Matthew Akelman2,
  3. Sophia A Traven3,
  4. Shane K Woolf3,
  5. John W Xerogeanes4,
  6. Harris S Slone3
  1. 1College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
  2. 2Department of Orthopaedic Surgery and Rehabilitation, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
  3. 3Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
  4. 4Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia, USA
  1. Correspondence to Dr Harris S Slone, Orthopaedics, Medical University of South Carolina, Charleston, SC 29425, USA; sloneh{at}


Importance High-grade posterior cruciate ligament (PCL) tears can be a significant cause of patient morbidity and knee instability. The graft of choice for operative repair remains controversial, although recently there has been increased interest in quadriceps tendon (QT) as an autologous graft option.

Objective The purpose of this study was to perform a systematic review to assess reported clinical outcomes of PCL reconstructions using QT autografts.

Evidence review A comprehensive review of clinical studies was performed evaluating PCL reconstruction with QT autograft including a systematic search of PubMed, Scopus, Cochrane and Google Scholar databases, and reference lists of relevant papers. Clinical results, stability results, functional outcomes, range-of-motion outcomes, complications and morbidity, and the conclusions of each study were evaluated.

Findings Seven studies were included in the review of clinical results, including 145 subjects undergoing PCL reconstructions with QT autograft. All studies evaluated quadriceps tendon bone (QT-B) grafts. Among these seven studies, two included isolated PCL reconstruction while five included multiligamentous knee injury reconstruction. These studies suggest that QT-B autograft offers a viable graft option for primary PCL reconstruction with generally favourable patient-reported outcomes, knee stability and range of motion reported along with relatively low complication rates.

Conclusions and relevance Use of the QT-B autograft may be a reasonable graft option for PCL reconstruction. However, high-quality prospective studies are required to evaluate the long-term safety, efficacy and functional outcomes.

Level of evidence Level IV (Systematic review of Level IV studies).

  • knee
  • autografts
  • ligaments
  • posterior cruciate ligament
  • reconstructive surgical procedures

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  • Contributors Six authors between three institutions have contributed to this paper. All authors have participated in the research. AM: responsible for literature review, and writing introduction, methods, results and discussion. MA: aided with literature review and writing introduction, methods, results and discussion. SAT: aided writing introduction, methods, results and discussion. SKW: aided study design and writing introduction and discussion. JWX: aided in study design. HSS: responsible for study design, aided with writing introduction, methods, results and discussion.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethics approval was not required for this systematic review in accordance with the Medical University of South Carolina Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplemental information.

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