Contralateral Patellar Tendon and The Shelbourne Experience

Abstract

Between 1984 and December 2002, 211 patients underwent a revision anterior cruciate ligament reconstruction using a contralateral patellar tendon autograft. The patients were divided up into 3 groups. The first 2 groups consisted of individuals who had a primary ACL reconstruction from another surgeon, both intraarticular reconstructions (N = 103) and extraarticular reconstructions (N = 51). Patients in the third group (N = 57) underwent a primary ACL reconstruction by the senior author. Subjective questionnaires were received from 165 patients at longer than 2 years after surgery (mean time, 6.67 years). The mean subjective score for patients who had undergone a previous extraarticular procedure by another surgeon before revision ACL surgery was 77.4 points, which, statistically, is significantly lower than the mean of 87.9 for patients who had a previous intraarticular procedure by a different surgeon and 92.7 for patients who had a previous intraarticular procedure done by the senior author. Objective evaluation obtained for 126 patients at a mean of 4.0 years after surgery showed that only 57% of patients who had undergone a previous extraarticular procedure had both normal extension and normal flexion, which, statistically significant, was less than 74% for patients who underwent a previous intraarticular ACL reconstruction by the senior author and 67% for patients who had undergone previous intraarticular procedures by another surgeon (P = 0.0372). Objective stability was not, statistically, different significantly between groups (P = 0.6040). The use of a mini-arthrotomy with contralateral patellar tendon autograft for revision ACL reconstruction allows patients to consistently achieve the goals of restoring stability, range of motion, and function after surgery.