Quadriceps Tendon Press-Fit Autograft for ACL Reconstruction: A Reliable and Cost-Effective Fixation Technique

Background: Anterior cruciate ligament (ACL) tears are frequent ligamentous injuries that necessitate reconstruction in many cases. The patellar tendon and the hamstring tendon are the most frequently utilized autografts for reconstruction. However, both have certain disadvantages. Femoral tunnel widening after ACL reconstruction is a common phenomenon. Moreover, the literature is still deficient regarding the results of using quadriceps tendon allograft and press fit technique of fixation. Aim of Study: The aim of this prospective case series study is to evaluate functional and clinical outcomes for quadriceps (QT) as an auto graft for anterior cruciate ligament reconstruc-tion (ACLR) using press fit technique. Patients and Method: A prospective case series study was undergone to patients at Cairo University Hospital (Kasr El-Aini), collecting data and follow-up were done from January 2022 till November 2024. Forty patients were operated using quadriceps tendon press fit technique and followed-up for one year. Pre- and post-operative clinical assessment using subjec-tive IKDC, IKDC examination form and lysholm scores for all patients to assess post-operative improvement regarding ROM and knee stability. Pre-operative MRI was done for all study members to confirm ACL injury and to address any associated ligamentous or meniscal injuries. Results: It was found that QT auto graft showed significant improvement of clinical and functional outcomes according to post-operative IKDC subjective (87.9±6.6) lysholm score (93±8). Clinically 95% of the patients had post-operative near-ly normal knee examination. Conclusion: The use of QT auto graft for primary ACLR gives similar clinical and functional outcome as other graft op-tions in the literature. Also, it was found that press fit technique for graft fixation is a good reliable technique with low cost and more biological than hardware using techniques.