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Ipsi- or Contralateral Patellar Tendon Graft in Anterior Cruciate Ligament Revision Surgery

A Comparison of Two Methods

Jüri Kartus, MD, Sven Stener, MD, Sven Lindahl, MD, PhD, Bengt I. Eriksson, MD, PhD and Jon Karlsson, MD, PhD^,||

Departments of Orthopaedics, Norra Älvsborgs Hospital Göteborg, Sweden
Department of Diagnostic Radiology, Norra Älvsborgs Hospital, Göteborg, Sweden
Department of Orthopaedics, Östra University Hospital, Göteborg, Sweden

Presented at the interim meeting of the AOSSM, San Francisco, California, February 1997.

|| Address correspondence and reprint requests to Jon Karlsson, MD, PhD, Department of Orthopaedics, Östra University Hospital, S-416 85 Göteborg, Sweden

Twenty-four patients who underwent anterior cruciate ligament revision surgery were studied postoperatively (12 with reharvested ipsilateral patellar tendon grafts and 12 with contralateral patellar tendon grafts). For comparison purposes, 12 matched patients with primary anterior cruciate ligament reconstruction, who had been operated on using the same technique by the same surgeons, were chosen. The median time since the first reconstruction was 57 months (range, 15 to 132) in the ipsilateral tendon group and 54 months (range, 20 to 108) in the contralateral tendon group. Follow-up examination showed that there were no significant differences in total KT-1000 arthrometer side-to-side measurements between the groups, but the Lysholm score was higher for patients with contralateral tendon grafts than for patients with ipsilateral grafts. Only two patients with ipsilateral grafts were classified as having excellent or good results. Functional testing outcomes were similar for all groups, and magnetic resonance imaging screening showed no differences between the reharvest and primary harvest groups in terms of length, width, thickness, or donor site gap of the patellar tendon. However, there were two major complications in the group with revision surgery with the ipsilateral reharvested patellar tendon. Reharvesting the ipsilateral patellar tendon resulted in lower functional scores and a higher rate of complications than revision with the contralateral patellar tendon or primary anterior cruciate ligament reconstruction.

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