Efficacy of β-Tricalcium Phosphate Graft into the Bone Defects after Bone-Patellar Tendon-Bone Anterior Cruciate Ligament Reconstruction.

This prospective pilot study investigated whether grafting β-tricalcium phosphate (B-TCP) into the bone-patellar tendon-bone (BPTB)-harvesting site after anterior cruciate ligament reconstruction would accelerate bone and tendon regeneration in the grafted site. Overall, 19 patients agreed prospectively to undergo regular morphological and histological examinations of the B-TCP-grafted site. Postoperative radiographic, ultrasonographic, and magnetic resonance imaging (MRI) examinations were performed to evaluate the grafted site at 1, 3, 6, and 12 months. Postoperative knee function and donor-site morbidity were assessed at 12 months using the kneeling test. A histological examination was also performed at this time Radiographic examination and MRI showed that the grafted B-TCP was completely absorbed and remodeled into normal bone structure in the tibia and patella at 6 months postoperatively. Histological and ultrasonographic examinations of all subjects showed that the grafted B-TCP was substituted by normal bone tissue, and the patellar tendon - bone junction had regenerated at 12 months postoperatively. Clinical functional knee tests showed good recovery of the donor site. All patients could perform kneeling and knee walking on hard ground. The results of this pilot study suggest that grafting B-TCP into the BPTB-harvesting site promotes the remodeling process of the bone and patellar tendon structures. This surgical treatment would decrease an incidence of the anterior knee pain after ACLR using a BPTB autograft.