The incidence of patellofemoral osteoarthritis and associated findings 7 years after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone autograft

To evaluate the development of postoperative patellofemoral osteoarthritis, we performed a retrospective clinical and radiographic study of 100 patien ts who had undergone anterior cruciate ligament reconstruction with a bone- patellar tendon-bone autograft an average of 7 years before the follow-up. Radiographic evaluation showed no patellofemoral osteoarthritis in 53 patie nts (group I), mild osteoarthritis in 34 patients (group II), moderate oste oarthritis in 12 patients, and severe osteoarthritis in 1 patient (group II I, moderate and severe changes). The average shortening of the patellar ten don was 2.4 mm in group I, 3.9 mm in group II, and 6.8 mm in group Iii. The placement of the femoral or tibial tunnel of the graft, as measured from l ateral radiographs, did not correlate significantly with the degree of pate llofemoral osteoarthritis. Patients who developed patellofemoral osteoarthr itis experienced worse final outcomes, were more often dissatisfied with th e condition of the operated knee, experienced more frequent pain and swelli ng in the knee joint, and had poorer range of motion and poorer quadriceps muscle strength than did patients without patellofemoral osteoarthritis. On ly three patients had an unstable knee, and degenerative changes in the tib iofemoral joint were uncommon.