BONE-PATELLAR TENDON-BONE GRAFT PREPARATION TECHNIQUE TO INCREASE CROSS-SECTIONAL AREA OF THE GRAFT IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Abstract

INTRODUCTION: Not much has changed in the way the bone-patellar tendon-bone graft is prepared before implantation. We present a modified bone-patellar tendon-bone graft preparation technique by implying the increased cross-sectional area. MATERIAL AND METHODS: Measurements of bone-patellar tendon-bone graft were made during the reconstruction of the anterior cruciate ligament in 93 male patients. The bone part of bone-patellar tendon-bone graft 10 mm wide and the tendon part 12-14 mm wide was placed on the holder with a handle in a way which allowed sewing the edges of the patellar tendon in a shape of a tube. The circumference of the central part of the graft was measured using a suture tightened around the graft. The diameters of the circle and cross-sectional areas were then calculated using geometrical calculation. RESULTS: After preparation of the bone-patellar tendon-bone graft, the fol- lowing measures were recorded: the circumference of 30 mm, the diameter of 9.55 mm, and the cross-sectional area of 72 mm2 in 9 patients; the circumference of 31mm, the diameter of 9.87 mm, and the cross-sectional area of 76 mm2 in 15 patients, and the circumference of 32 mm, the diameter of 10.19 mm, and the cross-sectional area of 82 mm2 in 69 patients. CONCLUSION: For the average thickness (3-5 mm) and width (10 mm) of the patellar tendon graft, the cross-sectional area will be 30-50 mm2. The modified bone-patellar tendon-bone graft preparation technique made it possible to increase its cross-sectional area to 71-81 mm2.