Clinical Evidence

Clinical Evidence Summary

*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.


    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

      These patients 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.

      Quadvantage Patient Post Rehabilitation

      Table References

      1. Quadvantage Clinical Experience 

      2. 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.

      3. 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.

      4. 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.

      5. 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.

      6. 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.

      7. Xerogeanes J. Quadriceps tendongraft for anterior cruciate ligament reconstruction: the graft of the future! Arthroscopy. 2019;35(3)696-697.

      8. Cerulli G, Placella G, Sebastiani E, Tei MM, Speziali A, Manfreda F. ACL reconstruction: choosing the graft. Joints. 2013;1(1):18-24.

      9. 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.

      10. 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.

      11. Stucken C, Garras DN, Shaner JL, Cohen SB. Infections in anterior cruciate ligament reconstruction. Rothman Institute. 2013. Papwer 59. Available at: Accessed October 5, 2019.

      12. 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.

      13. Shelton W, Fagan B. Autografts Commonly Used in Anterior Cruciate Ligament Reconstruction. J Am Acad Orthop Surg. 2011;19:259-264.

      14. Centers for Disease Control. MMWR Weekly-Update:Allograft associated bacterial infections-United States, 2002. Available at: Accessed October 5, 2019.

      15. Eagan M, McAllister D. Biology of allograft incorporation. Clin Sports Med. 2009;28:203-214.

      16. 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.

      17. 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

      18. Transparency Research 2021 Report – on file at QuadVantage

      Relevant Articles

      Refer to the Company’s website at for live links to these articles.  These articles refer to the advantages associated with using a Quadriceps tendon graft for ACL Reconstruction and do not address use of QuadVantage procedures and instrumentation.

      The information available on or through our website is not a part of this Form C.

      1. Quadriceps Tendon Autograft Versus Bone–Patellar Tendon–Bone and Hamstring Tendon Autografts for Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis – WenliDai, XiLeng, Jian Wang, Jin Cheng, Xiaoqing Hu, Yingfang Ao, 2021 (
      2. The Quad Tendon Graft for ACL Reconstruction — THE SPORTS MEDICINE MINUTE ( of a Quad Tendon Graft.
      3. Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Outcomes for Quadriceps Tendon Autograft Versus Bone–Patellar Tendon–Bone and Hamstring-Tendon Autografts – Dany Mouarbes, Jacques Menetrey, Vincent Marot, Louis Courtot, Emilie Berard, Etienne Cavaignac, 2019 ( Results with Quadricepts.
      4. Increased Risk of Revision After Anterior Cruciate Ligament Reconstruction With Soft Tissue Allografts Compared With Autografts: Graft Processing and Time Make a Difference – Gregory B. Maletis, Jason Chen, Maria C.S. Inacio, Rebecca M. Love, Tadashi T. Funahashi, 2017 ( Risk of Failure for Allografts.
      5. Increased incidence of osteoarthritis of knee joint after ACL reconstruction with bone-patellar tendon-bone autografts than hamstring autografts: a meta-analysis of 1,443 patients at a minimum of 5 years – PubMed ( Risk of Arthritis.
      6. Is Quadriceps Tendon a Better Graft Choice Than Patellar Tendon? A Prospective Randomized Study – Arthroscopy ( Better Graft.
      7. Return to Daily Activities.
      8. Quadriceps Tendon Graft for Anterior Cruciate Ligament Reconstruction: THE GRAFT OF THE FUTURE! – Arthroscopy ( of the Future.
      9. MRI Signal Intensity of Quadriceps Tendon Autograft and Hamstring Tendon Autograft 1 Year After Anterior Cruciate Ligament Reconstruction in Adolescent Athletes – Alexandra H. Aitchison, David. Alcoloumbre, Douglas N. Mintz, Sofia Hidalgo Perea, Joseph T. Nguyen, Frank A. Cordasco, Daniel W. Green, 2021 ( in Pediatrics.
      10.!&&p=1e3b20f526980cb0170bdf6551c1d2ec47cc39b514a515ca18d978bd87066a65JmltdHM9MTY1NDIwMDI3MSZpZ3VpZD02YWUxZGRlZC1iNTIzLTQzZmQtODk5OS00YWM0NWEwNThhMmMmaW5zaWQ9NTE3NA&ptn=3&fclid=3700f838-e2af-11ec-bb71-d4cc3967a14e&u=a1aHR0cHM6Ly9oanJhZGlvbG9neS5vcmcvaW5kZXgucGhwL0hKUi9hcnRpY2xlL2Rvd25sb2FkLzQ2MS8zMDE&ntb=1Quicker return to athletic Activities.
      11. Quadriceps tendon has a lower re-rupture rate than hamstring tendon autograft for anterior cruciate ligament reconstruction – A meta-analysis – Journal of ISAKOS ( Lower Risk of Failure

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