ACL reconstruction using an abnormally thick autogenous patellar tendon graft.

This prospective study measured the patellar tendon thickness of 543 patients who underwent anterior cruciate ligament (ACL) reconstruction with an autogenous bone-patellar tendon-bone graft to document the normal range of patellar tendon thickness and to determine if using thicker than normal patellar tendons as an ACL graft source affected postoperative outcome. The postoperative results of 55 patients who underwent ACL reconstruction with a patellar tendon > or =7 mm thick (thick tendon group) were compared with those of 488 patients who underwent ACL reconstruction with a patellar tendon < or =6 mm thick (normal tendon group). 5 mm (4.5 mm in women and 5.3 mm in men) with a range of 3-11 mm (3-7 mm in women and 3-11 mm in men). There was no statistically significant difference in the postoperative KT-1000 arthrometer mean manual maximum difference (2.0 mm for grafts < or =6 mm thick and 1.9 mm for grafts > or =7 mm thick), postoperative quadriceps muscle strength scores, modified Noyes questionnaire subjective scores (mean of 91 points for grafts < or =6 mm thick and 92 points for grafts > or =7 mm thick), or postoperative stability and pain scores. These results indicate that an abnormally thick patellar tendon should not preclude the use of this involved tendon as a graft source for ACL reconstruction.