Bone tunnel enlargement after anterior cruciate ligament reconstruction: fact or fiction?

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 19. J Orthop Surg Res. 2021 Jan 28;16(1):92. doi: 10.1186/s13018-021-02244-5. A cadaveric study of the location and morphology of the central patellar ridge for bone-patellar tendon-bone graft. Tanpowpong T(1), Itthipanichpong T(2), Huanmanop T(3), Jaruthien N(1), Tangchitcharoen N(1). Author information: (1)Department of Orthopaedics, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross society, Bangkok, Thailand. (2)Department of Orthopaedics, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross society, Bangkok, Thailand. thunthedoc@gmail.com. (3)Department of Anatomy, Chulalongkorn University, Bangkok, Thailand. INTRODUCTION: The central ridge of the patella is the thickest area of patella and varies among patients. This cadaveric study identified the location and thickness of the bone at the central patella ridge for bone-patellar tendon-bone (BPTB) harvesting. MATERIALS AND METHODS: Fifty cadaveric knees were assessed. First, the morphology, length, width, and location of the central patellar ridge were recorded. Then, we transversely cut the patella 25 mm from the lower pole and measured the thickness of the anterior cortex, cancellous bone, and cartilage from both the mid-patella and the central ridge location. Finally, the depth of the remaining cancellous bone at the mid-patella was compared to the bone at the central ridge. RESULTS: The location of the central-patellar ridge deviated medially from the mid-patella in 46 samples with an average distance of 4.36 ± 1 mm. Only 4 samples deviated laterally. The mean patella length was 41.19 ± 4.73 mm, and the width was 42.8 ± 5.25 mm. After a transverse cut, the remaining cancellous bone was significantly thicker at the central ridge compared to the bone at the mid-patella. CONCLUSIONS: Most of the central patellar ridge deviated medially, approximately 4 mm from the mid-patella. Harvesting the graft from the central ridge would have more remaining bone compared to the mid-patella. DOI: 10.1186/s13018-021-02244-5 PMCID: PMC7845110