Krosser B I, Bonamo J J, Sherman O H
Department of Orthopedic Surgery, New York University Medical Center, New York USA.
Am J Knee Surg. 1996 Fall;9(4):158-60.
Shortening of the patellar tendon after anterior cruciate ligament (ACL) reconstruction has been implicated as a cause of postoperative complications such as anterior knee pain, patella infera syndrome, and traumatic patellar tendon rupture. This prospective study was designed to asses whether closure of the patellar tendon defect during ACL reconstruction with mid-third bone-patellar tendon-bone autograft leads to radiographic evidence of patellar tendon shortening. One hundred fourteen patients underwent arthroscopically assisted ACL reconstruction using mid-third bone-patellar tendon-bone autograft. Group I (59 patients) had the patellar tendon defect left open. Group II (55 patients) had the defect sutured closed. The paratenon was approximated in all patients. Lateral knee radiographs were taken pre- and post-operatively. The pre- and postoperative patellar tendon lengths were measured and compared. Group I (defect left open) showed virtually no patellar tendon shortening (average 0.3%). Group II (defect closed) showed minimal but slightly more shortening (average: 0.51%). The maximum shortening was 2.3% in Group I and 4.3% in Group II. Therefore, closure of the patellar tendon defect does not significantly alter the length of the patellar tendon after ACL reconstruction.
前交叉韧带（ACL）重建术后髌腱缩短被认为是导致术后并发症的原因，如前膝痛、低位髌骨综合征和创伤性髌腱断裂。本前瞻性研究旨在评估在使用中三分之一骨-髌腱-骨自体移植物进行ACL重建时，闭合髌腱缺损是否会导致髌腱缩短的影像学证据。114例患者接受了关节镜辅助下的中三分之一骨-髌腱-骨自体移植物ACL重建。第一组（59例患者）髌腱缺损保持开放。第二组（55例患者）将缺损缝合闭合。所有患者的腱旁组织均进行了缝合。术前和术后拍摄膝关节外侧X线片。测量并比较术前和术后髌腱长度。第一组（缺损保持开放）几乎没有髌腱缩短（平均0.3%）。第二组（缺损闭合）显示出最小但略多的缩短（平均：0.51%）。第一组最大缩短为2.3%，第二组为4.3%。因此，在ACL重建后，闭合髌腱缺损不会显著改变髌腱的长度。
