Clinical Evidence Summary

ACL Reconstruction Techniques	Quadvantage Quad Autograft	Patellar Autograft (Current Lead Method)	Patellar Allograft (Cadaver)	Hamstring Graft (Next behind Patellar)
Technical Difficulty	Simple No Bone Plug Similar level of difficulty as Allograft procedure ^,1 With Single Bone* Plug Lower level of difficulty than Patellar Autograft and Hamstring procedure ^*,1	Moderate Dual bone plug Excised in unguided manner; requires high skill level Limited to graft availability	Simple Does not require a separate incision, however requires highly specialized fixation techniques	Moderate Requires harvesting of hamstring bundle
Size	Wide range ^2,3	Limited by size ⁴	Limited by size ⁴	Inconsistent ^3,5
Strength	Strongest^4,6,7	Normally adequate ⁸	Normally adequate ⁸	Weaker ⁸ Variable and sometimes inadequate (~15%) *
Tensile Properties	More favorable than patellar graft ⁶	Less favorable than quad tendon graft ⁶	Less favorable than quad tendon graft ⁶	Significant variability ⁹ Higher laxity *
Regeneration	Yes ⁷	Yes (Limited) ⁷	No	Not Completely
Failure Risk	Very Low ⁶	Low ¹⁰	Higher (almost 24% in <40 yrs old) ^11,12	Low ¹⁰
Graft Disease Transmission Risk	No ¹¹	No ¹¹	Yes ^11,13,14	No ¹¹
Graft Rejection Risk	No ¹⁵	No ¹⁵	Yes ¹⁵	No ¹⁵
Post Op Pain	Low ¹	Higher than hamstring tendon graft ¹⁶	Low ¹	Less than patellar autograft ¹⁶
Chronic Pain	Low ¹	Potential development of osteoarthritis reported ¹⁷	Low ¹	Potential development of osteoarthritis reported ¹⁷
Scar/Aesthetics	Small	Large	Small	Small

*Based on the experience of 5 surgeons, with experience across all graft types, who completed over 100 cases during the last 5 years using the QuadVantage Instrument Set. Guides for ensuring a consistent bone plug size and shape, forming of the harvested tendon and ease of amputation of the tendon, once harvested, minimized the level of expertise required to achieve consistent results. Additionally, lower site morbidity was observed in all cases vs Patellar Autograft procedures.

Testimonials

”I have had multiple surgeries, one of which was an ACL repair on my left knee. I had initial success, but recovery was longer than anticipated and I’m having issues long term. I recently had to have my right knee’s ACL repaired so I went to a new surgeon and he used the QuadVantage (QV) system… I was back on my feet in less time, had to have less meds and am not experiencing the issues I had with my other knee operation.”

Female Patient

“Minimal pain from the harvest site compared to hamstrings or the patellar tendon. I am surprised how painless they are at the harvest site even one week post-op. This, of course, relates to less pain in rehab and quicker return of quad function than patellar harvests”.

Board Certified Orthopedic Surgeon

Cosmetically Superior

QV Procedure Scar – 3 months post-op

This patient had a QV procedure 2 years ago: Scar is practically invisible

The patients above had ACL reconstruction using autogenous grafts. The patient on the left used a conventional Patellar graft. The patient on the right used a Quadriceps tendon graft taken with the QuadVantage System.

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Table References

Quadvantage Clinical Experience
Sheean AJ, Musahl V, Slone HS, et al. Quadriceps tendon autograft for arthroscopic knee ligament reconstruction: use it now, use it often. Br J Sports Med. 2018;52:698–701.
Sloan HS, Romine SE, Premkumar A, Xerogeanes JW. Quadriceps tendon autograft for anterior cruciate ligament reconstruction: a comprehensive review of current literature and systematic review of clinical results. Arthroscopy. 2015;31(3):541-554.
Harris NL, Smith DAB, Lamoreau L, Purnell M. Central quadriceps tendon for anterior cruciate ligament reconstruction part I: morphometric and biomechanical evaluation. Am J Sports Med.1997;25(1):23-28.
Magnussen RA, Lawrence TR, West FL, Toth AP, Taylor DC, Garrett WE. Graft size and patient age are predictors of early revision after anterior cruciate ligament reconstruction with hamstring autograft. Arthroscopy. 2012.28(4):526-531.
Mouarbes D,Menetrey J, Maro V, Courtot L, Berard E, Cavaignac E. A systematic review and meta- analysis of outcomes for quadriceps tendon autograft versus bone–patellar tendon–bone and hamstring-tendon autografts. Am J SportsMed. 2019;doi:10.1177/0363546518825340.
Xerogeanes J. Quadriceps tendongraft for anterior cruciate ligament reconstruction: the graft of the future! Arthroscopy. 2019;35(3)696-697.
Cerulli G, Placella G, Sebastiani E, Tei MM, Speziali A, Manfreda F. ACL reconstruction: choosing the graft. Joints. 2013;1(1):18-24.
Boniello MR, Schwingler PM, Bonner JM, Robinson SP, Cotter A, Bonner K. Impact of hamstring graft diameter on tendon strength: A biomechanical study. Arthroscopy. 2015;31(6):1084-1090.
Samuelsen BT, Webster KE, Johnson NR, Hewett TE, Krych AJ. Hamstring autograft versus patellar tendon autograft for ACL reconstruction: is there a difference in graft failure rate? A meta-analysis of 47,613 patients. Clin Orthop Relat Res.2017;475:2459–2468.
Stucken C, Garras DN, Shaner JL, Cohen SB. Infections in anterior cruciate ligament reconstruction. Rothman Institute. 2013. Papwer 59. Available at: https://jdc.jefferson.edu/rothman_institute/59. Accessed October 5, 2019.
Griffin LY, Albohm MJ, Arendt EA, et al. Understanding and preventing noncontact anterior cruciate ligament injuries: a review of the Hunt Valley II meeting, January 2005. Am J Sports Med. 2006;34(9):1512-1532.
Shelton W, Fagan B. Autografts Commonly Used in Anterior Cruciate Ligament Reconstruction. J Am Acad Orthop Surg. 2011;19:259-264.
Centers for Disease Control. MMWR Weekly-Update:Allograft associated bacterial infections-United States, 2002. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5110a2.htm. Accessed October 5, 2019.
Eagan M, McAllister D. Biology of allograft incorporation. Clin Sports Med. 2009;28:203-214.
Okoroha KR, Keller RA, Jung EK, et al. Pain assessment after anterior cruciate ligament reconstruction: bone–patellar tendon–bone versus hamstring tendon autograft. Orthop J Sports Med. 2016; doi: 10.1177/2325967116674924.
Barenius B, Ponzer, S, Shalabi A, Bujak R, Norlen L, Eriksson K. Increased Risk of Osteoarthritis After Anterior Cruciate Ligament Reconstruction: A 14-Year Follow-up Study of a Randomized Controlled Trial. AmJ Sports Med.2014;42(5):1049-1057
Transparency Research 2021 Report – on file at QuadVantage

Clinical Evidence Summary

Testimonials

Cosmetically Superior

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