Journal of experimental orthopaedics · 2025
Long-term results of anterior cruciate ligament reconstruction using the medial third of the patellar tendon.
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Georgoulis Jim, Savvidou Olga, Paschos Nikolaos, Kosta Paraskevi, Patras Kostas, Argyropoulou Maria, Papagelopoulos Panayiotis, Georgoulis Anastasios
Аннотация
PURPOSE: To report long-term outcome of anterior cruciate ligament reconstruction (ACLR) using the medial third of the patellar tendon in terms of knee function evaluated with clinical assessments, patient-reported outcomes (PROs) and radiological examinations.
METHODS: Forty patients were retrospectively evaluated 16.8 ± 0.3 (range 16.2-17.4) years after the index operation for anterior knee pain, side-to-side difference in anterior tibial translation (ATT), Lysholm score, Tegner score, subjective International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS) and radiographic evidence of osteoarthritis (Kellgren-Lawrence osteoarthritis [OA] grading).
RESULTS: Incidence of donor-site knee pain was 7.5% and the severity of the pain ranged 0.5-5.5 on visual analogue scale. Incidence of kneeling pain was 17.5% and the severity of pain ranged 3-7. There were no evidence for side-to-side differences in ATT (operated: 2.0 ± 0.7 vs. intact: 2.0 ± 0.9, p = 0.867). Lysholm had very large correlation with KOOSQoL (0.77 [0.58; 0.90], p < 0.001). IKDC had very large correlations with KOOSsports and KOOSQoL (0.75 [0.56; 0.87], p < 0.001 and 0.70 [0.48; 0.85], p < 0.001). KOOSsports and KOOSADL had the strongest correlation (0.79 [0.60; 0.91], p < 0.001). Approximately 55% of the sample had IKDC Z-score higher than age-matched population average and approximately 75%-80% of the sample was above the established PASS thresholds. The operated side exhibited more pronounced progression of knee osteoarthritis (higher K-L grade) (χ 2 = 12.9, p = 0.002); however only five knees in total (four operated, one intact) had Grade 2 radiographic OA.
CONCLUSIONS: Long-term clinical outcomes following ACLR with the medial third of the patellar tendon demonstrate a low incidence of anterior knee pain, excellent anterior-posterior stability and low rate of mild radiographic osteoarthritis. The majority of patients had achieved acceptable knee function and symptom resolution. These findings suggest that the medial third of the patellar tendon autograft is a reliable option for achieving sustained knee function and high patient satisfaction in the long term.
LEVEL OF EVIDENCE: Level IV.
METHODS: Forty patients were retrospectively evaluated 16.8 ± 0.3 (range 16.2-17.4) years after the index operation for anterior knee pain, side-to-side difference in anterior tibial translation (ATT), Lysholm score, Tegner score, subjective International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS) and radiographic evidence of osteoarthritis (Kellgren-Lawrence osteoarthritis [OA] grading).
RESULTS: Incidence of donor-site knee pain was 7.5% and the severity of the pain ranged 0.5-5.5 on visual analogue scale. Incidence of kneeling pain was 17.5% and the severity of pain ranged 3-7. There were no evidence for side-to-side differences in ATT (operated: 2.0 ± 0.7 vs. intact: 2.0 ± 0.9, p = 0.867). Lysholm had very large correlation with KOOSQoL (0.77 [0.58; 0.90], p < 0.001). IKDC had very large correlations with KOOSsports and KOOSQoL (0.75 [0.56; 0.87], p < 0.001 and 0.70 [0.48; 0.85], p < 0.001). KOOSsports and KOOSADL had the strongest correlation (0.79 [0.60; 0.91], p < 0.001). Approximately 55% of the sample had IKDC Z-score higher than age-matched population average and approximately 75%-80% of the sample was above the established PASS thresholds. The operated side exhibited more pronounced progression of knee osteoarthritis (higher K-L grade) (χ 2 = 12.9, p = 0.002); however only five knees in total (four operated, one intact) had Grade 2 radiographic OA.
CONCLUSIONS: Long-term clinical outcomes following ACLR with the medial third of the patellar tendon demonstrate a low incidence of anterior knee pain, excellent anterior-posterior stability and low rate of mild radiographic osteoarthritis. The majority of patients had achieved acceptable knee function and symptom resolution. These findings suggest that the medial third of the patellar tendon autograft is a reliable option for achieving sustained knee function and high patient satisfaction in the long term.
LEVEL OF EVIDENCE: Level IV.