Сhanges in the donor site following bone-patellar tendon-bone graft harvesting with open or closed defects
Background. The patellar tendon is frequently used as a graft source for anterior cruciate ligament reconstruction. The search of the factors that enhance the healing process of the donor site may contribute to improved anatomical and functional outcomes. The aim of the study — to determine the f...
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Vreden Russian Research Institute of Traumatology and Orthopedics
2024-12-01
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| Series: | Travmatologiâ i Ortopediâ Rossii |
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| Online Access: | https://journal.rniito.org/jour/article/viewFile/17606/pdf |
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| author | Pavel A. Trachuk Aleksandr P. Trachuk Oleg E. Bogopolskiy |
| author_facet | Pavel A. Trachuk Aleksandr P. Trachuk Oleg E. Bogopolskiy |
| author_sort | Pavel A. Trachuk |
| collection | DOAJ |
| description | Background. The patellar tendon is frequently used as a graft source for anterior cruciate ligament reconstruction. The search of the factors that enhance the healing process of the donor site may contribute to improved anatomical and functional outcomes.
The aim of the study — to determine the features of the harvesting techniques for better donor site healing by examining postoperative changes in the patellar tendon following two different graft harvesting methods.
Methods. This study examined the condition of the patellar tendon after two methods of graft harvesting under the same early mobilization protocols. Group 1 (retrospective) enrolled 30 patients who underwent follow-up MRI at different times after surgery, during which ligamentous and bony defects were not closed. Group 2 (prospective) included 30 patients who received full-layer suturing of the patellar tendon and patellar and tibial bone defects plasty. Postoperatively, all patients underwent radiography and the Insall-Salvati ratio of their patellar position was evaluated. In Group 2, MRI was performed preoperatively and 12 months post-surgery, while CT scans were taken 1 day and 6 months post-surgery. MRI was utilized to measure the size and qualitatively assess the condition of the tendon, whereas bone defects were evaluated on CT scans.
Results. The Insall-Salvati ratio of patellar position was within the physiological norm and did not differ between the groups (M1 = 1.11; SD1 = 0.13 and M2 = 1.12; SD2 = 0.15; p = 0.955). In Group 2, after 12 months, the length of the tendon was 3.1% shorter (M = -1.4 mm; SD = 2.4 mm; p = 0.003). The width of the tendon in the upper third and middle third was slightly increased (M = 0.3 mm; SD = 2.4 mm; p = 0.502 and M = 0.5 mm; SD = 2.1 mm; p = 0.205), while in the lower third it was 2.7% larger (M = 0.7 mm; SD = 1.7 mm; p = 0.034). The thickness of the tendon increased by 55% (M = 2.4 mm; SD = 1.6 mm; p = 0.001). All patients in Group 1 exhibited persistent bony and ligamentous defects. In Group 2, six months after surgery, cancellous bone filled the defects and integrated with the bone bed; 12 months later, the tendon was healed, and its shape and size approximated preoperative parameters.
Conclusion. Full-layer suturing of the patellar tendon, reconstruction of defects using cancellous bone autograft, and early mobilization promote the healing of bone defects and restore the integrity, shape, and size of the tendon. |
| format | Article |
| id | doaj-art-321bd9bdd1434096935ea2372a210f05 |
| institution | Kabale University |
| issn | 2311-2905 2542-0933 |
| language | Russian |
| publishDate | 2024-12-01 |
| publisher | Vreden Russian Research Institute of Traumatology and Orthopedics |
| record_format | Article |
| series | Travmatologiâ i Ortopediâ Rossii |
| spelling | doaj-art-321bd9bdd1434096935ea2372a210f052025-01-20T02:43:24ZrusVreden Russian Research Institute of Traumatology and OrthopedicsTravmatologiâ i Ortopediâ Rossii2311-29052542-09332024-12-01304607110.17816/2311-2905-176061382Сhanges in the donor site following bone-patellar tendon-bone graft harvesting with open or closed defectsPavel A. Trachuk0https://orcid.org/0000-0002-4442-5831Aleksandr P. Trachuk1https://orcid.org/0009-0005-5457-0003Oleg E. Bogopolskiy2https://orcid.org/0000-0002-4883-0543Vreden National Medical Research Center of Traumatology and OrthopedicsVreden National Medical Research Center of Traumatology and OrthopedicsVreden National Medical Research Center of Traumatology and OrthopedicsBackground. The patellar tendon is frequently used as a graft source for anterior cruciate ligament reconstruction. The search of the factors that enhance the healing process of the donor site may contribute to improved anatomical and functional outcomes. The aim of the study — to determine the features of the harvesting techniques for better donor site healing by examining postoperative changes in the patellar tendon following two different graft harvesting methods. Methods. This study examined the condition of the patellar tendon after two methods of graft harvesting under the same early mobilization protocols. Group 1 (retrospective) enrolled 30 patients who underwent follow-up MRI at different times after surgery, during which ligamentous and bony defects were not closed. Group 2 (prospective) included 30 patients who received full-layer suturing of the patellar tendon and patellar and tibial bone defects plasty. Postoperatively, all patients underwent radiography and the Insall-Salvati ratio of their patellar position was evaluated. In Group 2, MRI was performed preoperatively and 12 months post-surgery, while CT scans were taken 1 day and 6 months post-surgery. MRI was utilized to measure the size and qualitatively assess the condition of the tendon, whereas bone defects were evaluated on CT scans. Results. The Insall-Salvati ratio of patellar position was within the physiological norm and did not differ between the groups (M1 = 1.11; SD1 = 0.13 and M2 = 1.12; SD2 = 0.15; p = 0.955). In Group 2, after 12 months, the length of the tendon was 3.1% shorter (M = -1.4 mm; SD = 2.4 mm; p = 0.003). The width of the tendon in the upper third and middle third was slightly increased (M = 0.3 mm; SD = 2.4 mm; p = 0.502 and M = 0.5 mm; SD = 2.1 mm; p = 0.205), while in the lower third it was 2.7% larger (M = 0.7 mm; SD = 1.7 mm; p = 0.034). The thickness of the tendon increased by 55% (M = 2.4 mm; SD = 1.6 mm; p = 0.001). All patients in Group 1 exhibited persistent bony and ligamentous defects. In Group 2, six months after surgery, cancellous bone filled the defects and integrated with the bone bed; 12 months later, the tendon was healed, and its shape and size approximated preoperative parameters. Conclusion. Full-layer suturing of the patellar tendon, reconstruction of defects using cancellous bone autograft, and early mobilization promote the healing of bone defects and restore the integrity, shape, and size of the tendon.https://journal.rniito.org/jour/article/viewFile/17606/pdfpatellar tendonanterior cruciate ligamentdonor sitegraft harvesting technique |
| spellingShingle | Pavel A. Trachuk Aleksandr P. Trachuk Oleg E. Bogopolskiy Сhanges in the donor site following bone-patellar tendon-bone graft harvesting with open or closed defects Travmatologiâ i Ortopediâ Rossii patellar tendon anterior cruciate ligament donor site graft harvesting technique |
| title | Сhanges in the donor site following bone-patellar tendon-bone graft harvesting with open or closed defects |
| title_full | Сhanges in the donor site following bone-patellar tendon-bone graft harvesting with open or closed defects |
| title_fullStr | Сhanges in the donor site following bone-patellar tendon-bone graft harvesting with open or closed defects |
| title_full_unstemmed | Сhanges in the donor site following bone-patellar tendon-bone graft harvesting with open or closed defects |
| title_short | Сhanges in the donor site following bone-patellar tendon-bone graft harvesting with open or closed defects |
| title_sort | сhanges in the donor site following bone patellar tendon bone graft harvesting with open or closed defects |
| topic | patellar tendon anterior cruciate ligament donor site graft harvesting technique |
| url | https://journal.rniito.org/jour/article/viewFile/17606/pdf |
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