Document Title: Kartus-AJSM-Jul98.shtml
Article Title: Ipsi- or Contralateral Patellar Tendon Graft in Anterior Cruciate Ligament Revision Surgery: A Comparison of Two Methods
Authors: Jüri Kartus, MD, Sven Stener, MD, Sven Lindahl, MD, PhD, Bengt I. Eriksson, MD, PhD and Jon Karlsson, MD, PhD.
Publication: American Journal of Sports Medicine, Baltimore, Maryland
Date: July 1998
Volume 26, pages 499-504
Keywords: revision ACL reconstruction, autografting, patellar tendon, ipsilateral versus contralateral.

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Comments: Kartus et al. studied 24 ACL-revision-reconstruction knees. Of these knees, 12 underwent ipsilateral (same-knee) patellar-tendon reharvesting, while the remaining 12, the contralateral (opposite-knee) patellar tendon was harvested. The results for the former group were not as good as in the latter group. Therefore, it is not a good idea to reharvest an already-once-harvested patellar tendon. The best option was found to entail harvesting from the patellar tendon of the opposite knee (assuming no previous graft-harvesting was done from said knee). Note that in this study, the revision-reconstructed knees were graded on a scale rather than as failed-versus-successful.

ABSTRACT

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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