328 Patellar Height After Anterior Cruciate Ligament Rupture Reconstruction Using the Autologous Bone-Patellar Tendon-Bone Graft Technique in The Maltese Population

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Psaila ◽  
K Bugeja

Abstract Aim The primary aim of this study is to determine whether there is a change in patellar height after closure of the patellar tendon defect after a bone-patellar tendon-bone graft harvesting. The secondary aim is to evaluate clinical and functional outcomes. Method A retrospective observational study was conducted. Patients who were diagnosed with ACL injury and underwent reconstruction of ACL using the B-p-T-B graft technique from 2015 to 2020 were included (56 patients). All patients underwent the same procedural steps in the same centre. All patients had pre- and post-operative knee radiographs (antero-posterior and lateral views). The Caton- Deschamps Index was used to measure patellar height pre- and post-operatively. The International Knee Documentation Committee-Subjective Knee Evaluation Form was used to assess functional outcome. Clinical outcome was assessed by reviewing patient records. Results There was a change from the pre-op index 0.995 +/- 0.144 (mean +/- SD) to the post-op index 0.948 +/- 0.150. With a statistically significant decrease in index of 0.048 +/- 0.131 (p value 0.009) was found. The null hypothesis (that there is no change) is rejected and therefore the alternative hypothesis (a decrease in patellar height) is accepted. The mean IKDC-SKF score was 76.851 +/- 15.015 (SD) ranging from 40.2 to 100 Conclusions Performing ACL reconstruction using the B-pT-B technique, although predisposing to a decreased patellar height, it does not increase the incidence of patella baja. An overall good functional outcome was achieved, mean IKDC-SKF 76.85. However, no clear association between change in patellar height and PF symptoms could be demonstrated.

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Rachel Psaila ◽  
Kristian Bugeja ◽  
Lucienne Attard ◽  
Ivan Esposito

Abstract Aim The primary aim of this study is to determine whether there is a change in patellar height after closure of the patellar tendon defect after a bone-patellar tendon-bone graft harvesting. The secondary aim is to evaluate clinical and functional outcomes.  Method A retrospective observational study was conducted. Patients who were diagnosed with ACL injury and underwent reconstruction of ACL using the bone- patellar tendon- bone graft technique from 2015 to 2020 were included (56 patients). All patients underwent the same procedural steps. All patients had pre- and post-operative knee radiographs (antero-posterior and lateral views). The Caton- Deschamps Index was used to measure patellar height pre- and post-operatively. The International Knee Documentation Committee-Subjective Knee Evaluation Form was used to assess functional outcome. Clinical outcome was assessed by reviewing patient records.  Results There was a change from the pre-op index 0.995 +/− 0.144 (mean +/- SD) to the post-op index 0.948 +/− 0.150. With a statistically significant decrease in index of 0.048 +/− 0.131 (p value 0.009) was found. The null hypothesis (that there is no change) is rejected and therefore the alternative hypothesis (a decrease in patellar height) is accepted. The mean IKDC-SKF score was 76.851 +/− 15.015 (SD) ranging from 40.2 to 100. Conclusion Performing ACL reconstruction using the B-pT-B technique, although predisposing to a decreased patellar height, it does not increase the incidence of patella baja. An overall good functional outcome was achieved, mean IKDC-SKF 76.85. However, no clear association between change in patellar height and PF symptoms could be demonstrated.


Author(s):  
Dilip S. Shaktawat ◽  
Anil Kumar Mishra ◽  
Manoj R. Kashid ◽  
Amit Chaudhry ◽  
Rajshekhar . ◽  
...  

<p class="abstract"><strong>Background:</strong> Bone patellar tendon bone <strong>(</strong>BPTB) and hamstring (HT) auto grafts have been used routinely in reconstruction of ACL over past two decades. Controversy still remains as to which graft is superior over other. Many studies have compared these graft options using different implants and different methods of fixation. Continuation of efforts in the same direction; purpose of the study is to compare these two graft options utilizing identical implants and similar method of fixation.</p><p class="abstract"><strong>Methods:</strong> 40 patients of clinically and radiologically diagnosed ACL tear fulfilling the inclusion and exclusion criteria were randomized into two groups to undergo arthroscopic ACL reconstruction using quadrupled hamstring graft (n=20) and bone patellar tendon bone auto graft (n=20) utilizing bioscrew by aperture fixation method in both the groups. They were compared post operatively for symptomatic improvement, clinical and rolimeter laxity tests and Lysholm functional knee scoring at 02 year.<strong></strong></p><p class="abstract"><strong>Results:</strong> At the end of 02 years laxity measurement by rolimeter showed slightly better results in BPTB group; however it was not statistically significant (p value= 0.362). Knee pain at the end of 02 year was slightly more in HT groups (45%) as compared to BPTB group (35%) but not significant (p value =0.748). Instability symptoms are comparable in both the groups (sense of giving away on exertion). Manual laxity testing by Lachman and Pivot shift tests were comparable in both the groups with p value of 0.695 and 0.999 respectively. Lysholm functional knee score also showed no statistical significance (p value =0.957).</p><p><strong>Conclusions:</strong> There is no significant difference between HT and BPTB auto grafts in terms of clinical and functional outcome at the end of 02 years. </p>


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