Abstract
Purpose
To evaluate bone–patellar tendon–bone autograft anterior cruciate ligament reconstruction patellar defect dimensions over time and associate these with patient‐reported outcomes.
Methods
Patients undergoing bone–patellar tendon–bone autograft autograft anterior cruciate ligament reconstruction by 1 of 7 surgeons between June 2020 and June 2023 were recruited to obtain knee magnetic resonance imaging at 6 weeks and 1 year postoperatively and complete a knee injury and osteoarthritis outcome score (KOOS) survey at 1 year postoperatively. Patellar bony defect dimensions relative to the entire patellar dimensions were measured on magnetic resonance imaging and associated with KOOSs at 1 year.
Results
For the 23 patients (15 men) with a mean ± standard deviation age 25.5 ± 5.2 analyzed, shorter relative patellar defect length at 6 weeks postoperatively was associated with better 1‐year KOOS activities of daily living (
R
2
= 0.481,
P
= .002) and function in sports and recreation (
R
2
= 0.436,
P
= .002), and showed trends for associating with better pain (
R
2
= 0.196,
P
= .078) and knee‐related quality of life (
R
2
= 0.222,
P
= .054). Participants with longer relative defects were more likely to report difficulty with kneeling (
R
2
= 0.278,
P
= .020). These associations were not altered by considering patient age or sex. The average relative patellar defect width and depth decreased from 6 weeks to 1 year (
P
Conclusions
Shorter relative patellar defect length after bone–patellar tendon–bone autograft autograft anterior cruciate ligament reconstruction is associated with better patient‐reported outcome measures at 1 year, and thus, individual patient patellar size should be a consideration during graft harvest.
Level of Evidence
Level IV, retrospective case series.