Assessment of the patello femoral joint following ACL reconstruction, using patellar tendon graft versus hamstring quadrupled graft

ABSTRACT

The aim of this work was to study the effect of anterior cruciate ligament [ACL] reconstruction on the patello-femoral [PF] joint, comparing between the Patellar tendon [PT] graft and Hamstring [STG] quadrupled graft. The material consisted of 40 patients who had arthroscopic ACL reconstruction by PT and 37 patients by using STG graft. The minimum follow up period following surgery was one year in both groups. Patients were investigated clinically and radiologically regarding the PF joint. Anterior knee pain was present in 45% and 13.5% in both the PT group and the STG group with a significant difference. Patellar irritability and patellar crepitus were higher among the PT group. Flexion contracture was present in 20% and 5.4% in both PT and STG group respectively. There was a positive correlation between PF pain and patellar irritability, flexion contracture, and patellar crepitus in the PT group. Radiological investigation showed, a significant patellar tendon shortening [65%] among the PT group as compared from the preoperative status, measured by Insall/Salvati ratio. There was a significant decrease in the Merchant congruence angle [CA] in the PT group as compared from the preoperative recorded value. There was a significant correlation between PF pain and patellar tendon shortening, but not with the recorded CA in the PT group. The STG group did not show significant changes in the PT length, or CA. The Lateral patellofemoral angle and the sulcus angle did not show significant changes preoperatively or postoperatively