ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH PATELLAR TENDON-TIBIAL TUBEROSITY AS BONE-TENDON AUTO GRAFT. A NEW GRAFT TECHNIQUE

Purpose of Study 1- To introduce a new graft technique for ACL reconstruction using the patellar tendon with its attachment on the tibial tuberosity as bone-tendon (B PT) auto graft sparing the patella. 2-To assess the above described technique prospectively in a group of patients with ACL deficient knees. Type of study Prospective case series of a newly describedACL graft technique. Material and methods 44 patients with ACL deficient knee (with no other ligament injuries) were recruited to have ACL reconstruction using the above mentioned graft technique, there was 39 males and 5 females, average age at the index surgery was 24,4 year (range 20-40), the average time from injury to operation was 4 months (range 1 week to 1 year), the average follow up period was 30 months (ranged 24-35), there was 19 patients with isolated ACL injury and 25 with associated intra articular pathology including 22 meniscal tear, 8 with articular cartilage injury (3 of them associated with the meniscal tears). Those injuries were treated with meniscal repair (12 cases), partial menisectomy (10 cases), debridement and shaving +/− micro fracture technique for the articular cartilage injuries. Results at the final follow up all patients were satisfied with their knees, the IKDC improved from 68 +- 2.8(pre-op) to 92 +- 2.7 (CI-95%), and Lysholm score from 65 +- 3.2 to 93 +- 3(CI-95%) at the final visit. Anterior knee pain was reported in 4 patients (9%) on moderate to strenuous activities. 7 patients (16%) could not return to their pre-injury activity level. The mean difference in KT-1000 measurement was 2 +- 0.8. Conclusion our technique is effective with compatible results with other ACL graft9s technique with less complications rate when compared with PBTB auto graft, it avoids the remote incidence of patellar fractures, and reducing the incidence of anterior knee pain.