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Comparison of Traditional and Subcutaneous Patellar Tendon Harvest

A Prospective Study of Donor Site-Related Problems After Anterior Cruciate Ligament Reconstruction Using Different Graft Harvesting Techniques

Jüri Kartus, MD, PhD^*,, Lars Ejerhed, MD^*, Ninni Sernert, RPT^*, Sveinbjörn Brandsson, MD and Jon Karlsson, MD, PhD

^* Department of Orthopaedics, Norra Älvsborg Hospital, Trollhättan, Sweden
Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden

Address correspondence and reprint requests to Jüri Kartus, MD, PhD, Department of Orthopaedics, Norra Älvsborg Hospital, SE-461 85 Trollhättan, Sweden

Our goal was to compare the results after anterior cruciate ligament reconstruction using either the traditional one-incision or the subcutaneous two-incision technique to harvest the central third of the patellar tendon, particularly concerning disturbances in anterior knee sensitivity and the patient’s ability to walk on his or her knees. One surgeon performed anterior cruciate ligament reconstruction on 124 patients with unilateral ruptures and no history of previous incisions in the anterior knee region. The traditional one-incision graft harvesting technique was used in 58 patients and the subcutaneous two-incision technique was used in 66 patients. At 2 years, the International Knee Documentation Committee classification, Lysholm score, arthrometry side-to-side difference, and single-legged hop test showed no significant differences between groups. The area of insensitivity was a median of 24 cm² in the traditional harvest group and 0 cm² in the subcutaneous harvest group. The patients with subcutaneous harvest had a tendency toward fewer problems during walking on their knees than did the patients with traditional harvest. Our conclusion is that the subcutaneous two-incision graft harvesting technique caused less disturbance in anterior knee sensitivity and a tendency of less discomfort during walking on one’s knees than the traditional one-incision technique.

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