Patellar tendon graft position after anterior cruciate ligament reconstruction - Interobserver variability on lateral radiographs

We compared the reliability and validity of graft position measurements mad e by 4 orthopedic surgeons on intraoperative radiographs obtained using flu oroscopic control and postoperative radiographs obtained from the same 17 p atients 6 weeks after ACL reconstruction. Measurements from postoperative r adiographs varied significantly more than those from intraoperative radiogr aphs. There was little agreement between the postoperative and intraoperati ve measurements of the tibial and femoral graft position. We conclude that postoperative radiographs are not a sufficient tool for assessing graft pla cement after ACL reconstruction using patellar tendon autografts. In order to consider graft position in follow-up studies and to compare results from various surgeons, we suggest intraoperative fluoroscopy to produce radiogr aphs for accurate and reliable measurements.