Revision ACL reconstruction using autogenous patellar tendon graft

This retrospective study examined revision anterior cruciate ligament recon struction using a bone-tendon-bone autograft of the patellar ligament. We f ollowed up 44 patients (mean age 27.9 years) for an average of 41.2 months. Clinical examination with the Lachmann and pivot shift tests showed clearl y improved stability; KT-1000 arthrometer measurements had a mean differenc e of 3.5 mm in side-to-side comparison. The evaluated knee scores were sign ificantly improved (P<0.01); the median Lysholm score was 85 and the median Tegner activity score 5.0 at follow-up. In the IKDC ranking system 75.0% o f knees were rated normal or nearly normal (grades A and B). According to a modified Fairbank scale, progression of radiographic signs of osteoarthrit is was noted in 36.4%. There was a significant difference (P<0.05) in progr ession of radio-graphic signs of osteoarthritis between patients with major (grades III, IV) versus minor (grades I, II) lesions of the articular cart ilage surface and between knees with Versus without extensive synovitis due to previous synthetic graft reconstruction (P<0.05). Revision anterior cru ciate ligament reconstruction using an autogenous patellar tendon graft sho ws good results with improved knee function compared to the prerevision sta tus and is in line with various operative techniques described in the liter ature. Progression of osteoarthritis must be expected in patients with majo r lesions of the articular cartilage surface and knees with long-term exten sive synovitis due to previous anterior cruciate ligament reconstruction us ing synthetic grafts.