Quadriceps Tendon Graft

A quadriceps tendon graft is a strip of tendon taken from above the kneecap and shaped to replace a damaged ligament.

A quadriceps tendon graft is a strip of tendon collected from the front of the thigh, just above the kneecap. The surgeon prepares this tissue as a replacement for a damaged ligament, most often during ACL reconstruction. It is positioned through bone tunnels and secured so the knee can heal around the new ligament-like structure.

Quadriceps tendon tissue is broad and strong, with a useful amount of tissue for shaping. A graft may be prepared with a small piece of kneecap bone or as soft tissue alone, depending on the surgical plan. The choice also considers knee anatomy, activity goals, previous operations, and the condition of other tendons.

This graft is used mainly for reconstruction of the ACL, the knee ligament that helps control forward movement and rotation. The operation may be considered after a tear causes instability or when repair of the original ligament is not suitable. See [ACL Reconstruction](/treatments/sports-and-arthroscopic-surgery/acl-reconstruction/) for the wider procedure.

Other ACL graft choices can include tissue from the hamstring or patellar tendon, and some procedures use donor tissue. Each option has different effects on the harvest area, fixation method, rehabilitation, and suitability for the individual knee. Your surgeon can explain why one source fits your anatomy and goals.

The graft is not an instant replacement for normal ligament tissue. Early care focuses on swelling control, safe knee movement, and protecting the reconstruction. Physiotherapy then builds quadriceps strength, balance, and movement confidence. Returning to running, pivoting, or contact sport requires staged testing and clearance rather than a calendar date alone.

The graft becomes biologically incorporated as healing progresses, but its condition is affected by rehabilitation, reinjury, and the demands placed on the knee. Contact the surgical team for increasing pain, wound drainage, fever, marked calf swelling, or new loss of movement. Follow instructions about exercises, weight bearing, and brace use.