Evaluation of the donor site defect after harvesting the medial third of the patellar tendon in ACL reconstruction: An MRI study.
case_series · Level IV
Where this comes from
- Record sourced from PubMed, PMID 41323541.
- Also identified by DOI 10.1002/jeo2.70571 and PMC identifier 12661207.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
Previous studies have reported magnetic resonance imaging (MRI) changes in the donor-site defect size following anterior cruciate ligament reconstruction (ACLR) using the middle third of the patellar tendon (mid-third patellar tendon ACLR); however, no corresponding reports exist for ACLR using the medial third of the patellar tendon (medial-third patellar tendon ACLR). This study aimed to assess the changes in donor-site defect size postoperatively in medial-third ACLR patients and hypothesized a clinically relevant MRI change within the first year. Twenty-two consecutive patients underwent MRI examinations to measure the donor-site defect size ('gap' signal) and laterally remaining tendon size ('normal tendon' signal) at two time points: 14 (±5) days and 7.9 (±2.0) months postoperatively. The primary outcome was the post-pre difference of the "gap" signal. Wilcoxon signed rank test assessed the post-pre difference of the 'gap' signal, while robust linear regression examined the effect of either age at surgery or follow-up time on the post-pre difference of the 'gap' signal. The primary finding was a significant reduction in the 'gap' signal [-9.2 mm (95% CI: -12.3; -6.7)] between 2 weeks and ~8 months (<i>p</i> < 0.001). The 'normal tendon' signal did not change significantly [1.6 mm (95% CI: -0.5; 3.3), <i>p</i> = 0.237]. Age at surgery had a negative, statistically nonsignificant effect on donor-site 'gap' signal difference (-2.24 [95% CI: -5.59; 0.60], <i>p</i> = 0.106). In addition, follow-up time had a negative, statistically nonsignificant effect on donor-site 'gap' signal difference (-0.97 [95% CI: -2.98; 4.14], <i>p</i> = 0.571). Eight of 22 patients had no detectable 'gap' signal at 8 months. The most important finding for this study is a significant decrease in the donor-site defect along with an undetectable 'gap' that was verified for ~36% of the sample at a minimum mean follow-up of ~8 months. The laterally remaining 'normal tendon' signal remained unchanged. Neither age at surgery nor follow-up time had an impact on the healing of the donor-site defect. From a clinical perspective our findings suggest that the medial-third patellar tendon autograft has a high healing capacity after harvesting, already at a mean follow-up of ~8 months. Level IV.