World journal of orthopedics · 2026
Anterior knee pain in anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft and autologous bone grafting.
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Byravamoni Venugopal Adhitya, Chauhan Nitin, Wani Sunit, Maramreddy Leela Venkata Sai Krishna, Pathak Kushagra, Mittal Ravi
Аннотация
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BPTB) autografts remains the gold standard for young, active individuals due to its superior biomechanical strength and bone-to-bone healing. However, donor site morbidity, particularly anterior knee pain (AKP), limits its utilization despite its advantages. Various techniques have been proposed to reduce AKP, but they show variable outcomes and several limitations.
AIM: To assess the incidence and severity of AKP following BPTB ACL reconstruction using an autologous bone grafting technique.
METHODS: We conducted a retrospective observational study of 24 patients aged 20-45 years, who had primary ACL reconstruction with BPTB grafts. During surgery, autologous cancellous bone generated from tunnel drilling was used to fill the patellar and tibial donor site voids after graft fixation. All patients were followed up for at least twelve months. Using the Kujala Anterior Knee Pain Score, clinical outcomes were evaluated, including the pain-specific subcomponent.
RESULTS: With scores ranging from 86 to 100, the average overall Kujala score was 95.67 ± 4.01. No patient scored below 85. There was no complication such as patellar fracture, tibial tuberosity fracture, or infection. Grouped data showed 20.8% of patients scored 100, whereas 54.2% scored between 95 and 99, and 25% scored between 86 and 94. One patient (4.2%) had an 8/10 pain subcomponent, whereas 23 patients (95.8%) had a 10/10.
CONCLUSION: This procedure is easy to incorporate into routine surgical practice, cost-effective and reproducible without requiring extra incisions or raising the patient's surgical expenses. Excellent short-term results back up this technique.
AIM: To assess the incidence and severity of AKP following BPTB ACL reconstruction using an autologous bone grafting technique.
METHODS: We conducted a retrospective observational study of 24 patients aged 20-45 years, who had primary ACL reconstruction with BPTB grafts. During surgery, autologous cancellous bone generated from tunnel drilling was used to fill the patellar and tibial donor site voids after graft fixation. All patients were followed up for at least twelve months. Using the Kujala Anterior Knee Pain Score, clinical outcomes were evaluated, including the pain-specific subcomponent.
RESULTS: With scores ranging from 86 to 100, the average overall Kujala score was 95.67 ± 4.01. No patient scored below 85. There was no complication such as patellar fracture, tibial tuberosity fracture, or infection. Grouped data showed 20.8% of patients scored 100, whereas 54.2% scored between 95 and 99, and 25% scored between 86 and 94. One patient (4.2%) had an 8/10 pain subcomponent, whereas 23 patients (95.8%) had a 10/10.
CONCLUSION: This procedure is easy to incorporate into routine surgical practice, cost-effective and reproducible without requiring extra incisions or raising the patient's surgical expenses. Excellent short-term results back up this technique.