The tendon defect after anterior cruciate ligament reconstruction using the midthird patellar tendon--a problem for the patellofemoral joint?
Knee Surg Sports Traumatol Arthrosc
; 3(4): 194-8, 1996.
Article
em En
| MEDLINE
| ID: mdl-8739711
ABSTRACT
Retrospective clinical and radiographic evaluation was performed on 41 patients seen at the Salzburg General Hospital Department of Traumatology on average 2 years following ACL reconstruction. In 26 patients (61%) clinical examination revealed pain trigger points over the donor site of the midthird patellar tendon and in the patellofemoral joint. Functional pain during kneeling activities was observed in 19 patients (46%). Objective measurement of the length of the patellar tendon in bilateral radiographs demonstrated exactly equal patellar tendon length in both knees in 11 patients (27%). The radiographs showed tendon shortening following harvesting of the midthird patellar tendon by 1-3 mm in 7 patients (17%), by 4-6 mm in 16 (39%), and by 6-9 mm in 7 (17%). Average length change in the patellar tendon on the donor side was -3 mm, representing a patellar tendon shortening of 9.8%. On the basis of the OAK score, however, good and very good results were recorded in 33 patients (80%). On the whole, these good overall results were compromised only be patellar tendon defect morbidity. In addition to the local scarring problems at the donor site, shortening of the patellar tendon was observed with changes to patella position and interference with the mechanics of the patellofemoral joint. Tendon shortening can be explained on the basis of cicatricial contraction in the process of autorepair to the tendon defect. The problems affecting the patellofemoral joint are inherent in the therapy and must be treated as a negative factor. In the case of patients whose work requires mainly a kneeling position and those who make significant functional demands of the extension system of the knee, a critical assessment is required of the use of the midthird patellar tendon for anterior cruciate ligament reconstruction.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artroplastia
/
Ligamento Cruzado Anterior
/
Ligamento Patelar
/
Lesões do Ligamento Cruzado Anterior
/
Traumatismos do Joelho
/
Articulação do Joelho
Tipo de estudo:
Etiology_studies
/
Observational_studies
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Knee Surg Sports Traumatol Arthrosc
Assunto da revista:
MEDICINA ESPORTIVA
/
TRAUMATOLOGIA
Ano de publicação:
1996
Tipo de documento:
Article
País de afiliação:
Áustria