ACL Surgery 101

ACL injury

What is an ACL Injury?

An ACL injury is a tear or sprain of the anterior cruciate ligament (ACL). The ACL ligament is one of the major ligaments in your knee that helps connect your thigh bone (femur) to your shinbone (tibia). An ACL injury can be very painful, inhibit movement of the joint and limit a return to normal activities.

As society, at all ages, moves to more active lifestyles and participation in recreational and youth sports increases, the incidence of ACL injuries – and the need for better repair solutions – continues to climb.

According to data from Transparency Market Research 2021, over 900,000 ACL reconstruction surgeries are expected to be performed in North America and Europe in 2023. Active women experience a higher incidence of ACL injuries than men because their biomechanics tend to put more stress on their knees.

ACL Surgery 101

Mainstream ACL reconstruction techniques utilize Patellar, Hamstring or Allograft (cadaver) tendon grafts as replacements for the injured tendon. In some cases, a bone fragment (“plug”) is carved out of the kneecap and remains attached to one end of the soft tissue graft that is to be used as the replacement tendon.

Patellar Tendon Harvesting Procedure

The most common Patellar tendon graft procedure involves the extraction of two bone plugs, a large vertical scar and excision of the middle 1/3 of the Patellar tendon. While Patellar and Hamstring tendon grafts currently represent the majority of the ACL reconstruction “market”, key issues continue to plague patients that undergo these surgeries.

The most common issues with Patellar and Hamstring surgeries relate to short- and long-term pain, the use of narcotics to manage pain, graft strength/ risk of failure, length of rehabilitation and aesthetics (scarring). Allografts (cadaver) are sometimes used but are more expensive and have been shown to have a higher potential for failure.

The damaged ACL is removed.

An incision is made in the knee from the patella to the proximal tibia.

A graft and replacement ligament are harvested from the patellar region.

Clinical evidence

The Case For Quadriceps ACL Reconstruction Surgery

Published studies continue to show that the Quadriceps tendon provides significant advantages to Patellar, Hamstring and Cadaver tendons currently used in ACL reconstruction. The Quadriceps is known to regenerate over time, has higher tensile strength and has been shown to have a lower risk of failure. A sampling of relevant articles is shown below:

Quicker Recovery Less Medication

Short-Term Recovery After Anterior Cruciate Ligament Reconstruction: A Prospective Comparison of Three Autografts

Lower Post Surgery Complications (Morbidity)

Quadriceps Tendon Autograft Versus Bone–Patellar Tendon–Bone and Hamstring Tendon Autografts for Anterior Cruciate Ligament Reconstruction

Advantages of Quad Tendon Grafts

ACL Reconstruction: Should You Get a Quad Tendon Graft ?  

The Roadblock

Use of the Quadriceps tendon in ACL reconstruction surgery has generally remained the purview of high end specialists who perform the procedure by hand or with limited instrumentation that does not provide the precision we expect the QuadVantage solution to provide. As the evidence grows, we believe that, given the right surgical solution, the market is predisposed to adopt the Quadriceps tendon as the graft of choice. 

Invest in the future

QuadVantage Adds Precision and Simplifies Harvesting of the Quadriceps Tendon

QuadVantage addresses the complexity issue by providing surgeons with a reliable method and set of instrumentation that limits the amount of guesswork and manually guided (specialist) steps the surgeon has to take.

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