Does the patellar tendon normalize after harvesting its central third?: a prospective long-term MRI study

Area of Science:

• Orthopedic surgery
• Biomedical imaging
• Sports medicine

Background:

• The central third of the patellar tendon is a common autograft source for anterior cruciate ligament (ACL) reconstruction.
• Understanding the long-term healing and normalization of the patellar tendon donor site is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the MRI appearance of the patellar tendon donor site 6 years after harvesting its central third for ACL reconstruction.
• To determine if the patellar tendon returns to its normal state after graft harvesting.

Main Methods:

• Prospective study involving 19 patients undergoing ACL reconstruction.
• Serial MRI examinations of the patellar tendon donor site at multiple postoperative time points (6 weeks to 6 years).
• Comparison with the contralateral, unoperated patellar tendon.

Main Results:

• A significant decrease in the donor-site gap size was observed over 6 years (P = 0.0001).
• Persistent thinning of the central patellar tendon was noted in most patients at 6 years.
• Increased peripheral tendon thickness and overall width were observed compared to the contralateral side for up to 2 years and throughout the study, respectively.

Conclusions:

• The patellar tendon donor site does not fully normalize 6 years after central third harvesting.
• The findings indicate that reharvesting the patellar tendon is not recommended due to incomplete healing and altered tendon morphology.