Anterior cruciate ligament reconstruction: outcome using a patellar tendon bone (PTB) autograft (one bone block technique)

Arch Orthop Trauma Surg. 2009 Mar;129(3):323-31. doi: 10.1007/s00402-008-0724-5. Epub 2008 Aug 30.

Abstract

Objective: The aim of this study was to determine the outcome of anterior cruciate ligament (ACL) reconstruction using a patellar tendon bone autograft (one bone block technique).

Method: We retrospectively evaluated a case series of patients who had received arthroscopic ACL reconstructions using patellar tendon bone autograft. Fifty-four (54) ACL reconstructions were evaluated at a mean of 38 months (range 25-62 months). Clinical assessment was made using a modified Lysholm score, documentation of International Kappanee Documentation Committee (lKappaDC), the anterior knee pain questionnaire of Shelbourne and Trumper, and by KappaTau-Rolimeter arthrometric analysis. Radiographic assessments were also performed.

Results: Arthrometric analysis showed that 51 knees (94%) were graded Alpha or Beta with a median laxity of 2 mm, postoperatively. The Lysholm score improved postoperatively from 70 to 89. The patellar position in terms of congruence angle did not show any significant change, and the final shortening of the patellar tendon using the Insall-Salvati ratio was 6.07%. Only three patients complained of moderate pain on kneeling, one patient was unable to participate in strenuous works and one patient complained of harvest-site tenderness.

Conclusion: It is concluded that the use of patellar tendon autograft with a single tibial-tubercule bone block and a strip of patellar periosteum have the advantages of being available and comparable in terms of graft size and strength and shows satisfactory results with reduced anterior knee pain.

MeSH terms

  • Adult
  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries
  • Arthroscopy
  • Bone Transplantation*
  • Female
  • Humans
  • Knee Injuries / surgery
  • Knee Joint
  • Male
  • Middle Aged
  • Patellar Ligament / transplantation*
  • Retrospective Studies
  • Tibia / transplantation
  • Transplantation, Autologous
  • Treatment Outcome
  • Young Adult