Document Title: Jarvela-AJSM-Jan01

Article Title: The incidence of patellofemoral osteoarthritis and associated findings 7 years after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone autograft

Author: Timo Jarvela, Timo Paakkala, Pekka Kannus, Markku Jarvinen.

Publication: The American Journal of Sports Medicine

ISSN: 03635465

Date: January-February 2001.

(Figures included. Reference-denoting numbers appear in the same point size as document text.)

Volume: 29

Issue: 1

Pages: 18-24  

Key Words: Knee, arthritis, graft, patellar, tendon, bone.

 

This article discusses problems related chiefly to the patellar-tendon-graft harvesting process. Jarvela notes that in the follow-up study, tibiofemoral-compartment osteoarthritic changes were rare. The major problem observed was due to shortening of the patellar tendon. (Good post-surgery rehabilitation, including appropriate early mobilization and exercises, is the most essential preventive measure.)

 

ABSTRACT

 

To evaluate the development of postoperative patellofemoral osteoarthritis, we performed a retrospective clinical and radiographic study of 100 patients who had undergone anterior cruciate ligament reconstruction with a bone-patellar tendon-bone autograft an average of 7 years before the follow-up. Radiographic evaluation showed no patellofemoral osteoarthritis in 53 patients (group I), mild osteoarthritis in 34 patients (group II), moderate osteoarthritis in 12 patients, and severe osteoarthritis in 1 patient (group III, moderate and severe changes). The average shortening of the patellar tendon was 2.4 mm in group 1, 3.9 mm in group II, and 6.8 mm in group Ill. The placement of the femoral or tibial tunnel of the graft, as measured from lateral radiographs, did not correlate significantly with the degree of patellofemoral osteoarthritis. Patients who developed patellofemoral osteoarthritis experienced worse final outcomes, were more often dissatisfied with the condition of the operated knee, experienced more frequent pain and swelling in the knee joint, and had poorer range of motion and poorer quadriceps muscle strength than did patients without patellofemoral osteoarthritis. Only three patients each had an unstable knee to contend with, and degenerative changes in the tibiofemoral joint were uncommon.

 

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