Revision Anterior Cruciate Ligament Reconstruction with a Reharvested Ipsilateral Patellar Tendon

Abstract

The patellar tendon remains the most popular graft choice for anterior cruciate ligament reconstruction and has been proven to be the strongest substitute. Between 1991 and 1998, we performed revision anterior cruciate ligament reconstruction using the reharvested central third of the ipsilateral patellar tendon in 15 patients. Adequate follow-up was obtained in 13 of these 15 patients. The results in these 13 patients (mean age, 27.2 years) were reviewed. At an average postoperative follow-up of 39.4 months (range, 24 to 65), 11 patients had good or excellent results and 2 patients had fair results. Clinical examination revealed an average Tegner knee score of 5.8 (range, 3 to 9) and an average Lysholm knee score of 77.6 (range, 61 to 98). Postoperative KT-1000 arthrometer results showed an average side-to-side difference of 1.92 mm (range, -2.0 to 4.0). No patient demonstrated any loss of range of motion and only one reported patellofemoral problems, which were moderate. These favorable results demonstrate that, with appropriate patient selection, the use of a reharvested central third patellar tendon is a viable option for revision of a failed anterior cruciate ligament reconstruction.

Revision ACL reconstruction: influence of a lateral tenodesis

“…This is in accordance with the results recently published in two studies that recommend that when available, hamstring tendon autografts should be considered for revision ACL reconstruction [13,32]. Nonetheless, patellar tendon yields comparable results and is also validated by previous studies [10,22,41]. Therefore, one logical strategy could be to use ipsilateral BTB for revision of previous ST/G and ipsilateral ST/G for revision of previous BTB: The surgical knowledge of these two grafts may be necessary for the knee surgeon to solve revision ACL reconstruction problems.…”

Case series: Revision anterior cruciate ligament reconstructions using patellar tendon autografts

“…The rate of isolated biological graft failures in this study was determined to be 7%, similar to that in previous reports [7,9,16,27,28]. Interestingly, nine patients (17%) had a history of contralateral ACL ruptures before the revision surgery, and two (4%) experienced such injuries after their revision surgeries.…”

“…Interestingly, Colosimo et al [28] used reharvested BPTBs and reported that nine of 13 (69%) patients regained their pre-injury activity levels at the time of the follow-up. Hence, these reports also support our preference for using the BPTB revision graft.…”

Current Concepts Review: Revision Anterior Cruciate Ligament Reconstruction

“…O'Shea 68 Colosimo et al 13 Johnson et al 39 Noyes et al 53 Noyes and Barber-Westin 52 Taggart et al 74 Fules et al 18 Kartus et al 41 Uribe et al 78 Wirth the results of RACLR surgery are less favorable than the results of primary ACLR." This is apparently based on a comparison of his previously published results after PACLR, where 92% of patients were found to be IKDC normal or nearly normal, 54 compared with 84% after RACLR.…”