CPT William F. Scully, M. D. , CPT David J. Wilson, M. D

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“Central” Quadriceps Tendon Harvest With Patellar Bone Plug: Surgical Technique Revisited CPT William F. Scully, M.D., CPT David J. Wilson, M.D., COL Edward D. Arrington, M.D. Arthroscopy Techniques Volume 2, Issue 4, Pages e427-e432 (November 2013) DOI: 10.1016/j.eats.2013.06.004 Copyright © 2013 Terms and Conditions

Fig 1 Cadaveric anatomic exposure showing lateral-based insertion of quadriceps tendon on superior pole of patella. The probe is centered on the patella. Arthroscopy Techniques 2013 2, e427-e432DOI: (10.1016/j.eats.2013.06.004) Copyright © 2013 Terms and Conditions

Fig 2 Quadriceps tendon harvest with patellar bone plug. In the left image, the red lines show the dangerously lateral position of the patellar bone plug if the harvest location is based on the longest and most central portion of the quadriceps tendon. The blue lines depict the more medially based location of the harvested tendon when the patellar bone plug is centered, as proposed in our technique. Arthroscopy Techniques 2013 2, e427-e432DOI: (10.1016/j.eats.2013.06.004) Copyright © 2013 Terms and Conditions

Fig 3 (A) Anteroposterior and (B) sunrise radiographs of a postoperative ACL reconstruction procedure in which the patella was fractured during the quadriceps tendon bone plug harvest. When the fracture was identified, the plug was replaced in its harvest bed and the fracture was stabilized with 2 transverse cortical screws. Arthroscopy Techniques 2013 2, e427-e432DOI: (10.1016/j.eats.2013.06.004) Copyright © 2013 Terms and Conditions

Fig 4 Harvesting of patellar bone plug. The Steri-Strip on the saw blade marks the 1-cm line, which is the intended depth of the plug. Arthroscopy Techniques 2013 2, e427-e432DOI: (10.1016/j.eats.2013.06.004) Copyright © 2013 Terms and Conditions

Fig 5 Dislodging of patellar bone plug with osteotome. Arthroscopy Techniques 2013 2, e427-e432DOI: (10.1016/j.eats.2013.06.004) Copyright © 2013 Terms and Conditions

Fig 6 Completion of patellar bone plug harvest. Arthroscopy Techniques 2013 2, e427-e432DOI: (10.1016/j.eats.2013.06.004) Copyright © 2013 Terms and Conditions

Fig 7 Quadriceps tendon graft with patellar bone plug prepared for use in ACL reconstruction. Arthroscopy Techniques 2013 2, e427-e432DOI: (10.1016/j.eats.2013.06.004) Copyright © 2013 Terms and Conditions