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Abstract
The use of BPTB autograft is frequently used in ACL reconstruction, however, the risk of potential failure in patients with an anatomically unfavorable patellar tendon may predispose to reconstruction failure. Anatomical study of the extensor apparatus of the knee can provide knowledge about the best option obtain the graft and perform a better preoperative planning. Musculoskeletal ultrasound is a simple, reproducible, affordable technique that could be valid for patellar tendon evaluation. The objective of this study is to evaluate the reproducibility of the patellar tendon measurements by ultrasound and compare them with anatomical measurements, both in cadaver and patients undergoing ACLR. The study consists of two phases; first anatomical study in cadaver. The ultrasound measurement was performed by determining the length, width and thickness of the patellar tendon, both by ultrasound and anatomical dissection. The second phase is a cohort of 42 patients pending surgical ACLR. Previous ultrasound and intraoperative measurements were obtained. Regarding the anatomical study, statistical analysis did not show any differences comparing the measurements in length (p = ns) and thickness (p = ns) of the patellar tendon, although differences were obtained when comparing the results obtained for the width of the tendon after the ultrasound and anatomical measurement (p < 0.001). Same results were obtained in second phase of the study. The reproducibility of ultrasound measurements of the PT is comparable to intraoperatively measurements (without width measurement). These findings can be useful for preoperative planning in the reconstruction of ACL with BPTB Graft and to assess technical modifications prior to surgery.
Disclosure
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise and made the statistical study for this paper but no complex statistical study was performed. Institutional Review Board approval was obtained about the cadaveric study from ethical committee of Universitat Internacional de Catalunya (UIC). Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported. Methodology: The present study is performed in two phases, first of all, an anatomical experimental study and in a second phase, an experimental prospective cohort study performed in a single institution