ACL reconstruction using an abnormally thick autogenous patellar tendon graft

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Anterior cruciate ligament (ACL) reconstruction commonly uses autogenous bone-patellar tendon-bone grafts.
• The normal range of patellar tendon thickness is not well-established.
• The impact of using thicker-than-normal patellar tendons as graft sources on patient outcomes is unclear.

Purpose of the Study:

• To establish the normal range of patellar tendon thickness.
• To determine if using thicker patellar tendons (> or =7 mm) as ACL graft sources affects postoperative outcomes.
• To compare outcomes between patients receiving thicker vs. normal-sized patellar tendon grafts.

Main Methods:

• Prospective study of 543 patients undergoing ACL reconstruction.
• Measured patellar tendon thickness.
• Compared outcomes (KT-1000, quadriceps strength, Noyes scores, stability, pain) between a thick tendon group (>=7 mm) and a normal tendon group (<=6 mm).

Main Results:

• Normal patellar tendon thickness averaged 5.5 mm (4.5 mm in women, 5.3 mm in men), with a range of 3-11 mm.
• No significant differences in postoperative KT-1000 scores, quadriceps strength, Noyes scores, stability, or pain between the thick and normal tendon groups.
• Mean KT-1000 difference: 2.0 mm (normal) vs. 1.9 mm (thick).
• Mean Noyes score: 91 (normal) vs. 92 (thick).

Conclusions:

• Abnormally thick patellar tendons do not negatively impact ACL reconstruction outcomes.
• Thicker patellar tendons can be safely used as a graft source for ACL reconstruction.
• This finding expands graft options for ACL reconstruction surgery.