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Orthop J Sports MedOrthop J Sports MedOJSspojsOrthopaedic Journal of Sports Medicine2325-9671SAGE Publications Sage CA: Los Angeles, CA 10.1177/2325967118S0014210.1177_2325967118S00142ArticleAdvanced Patellar Tendinopathy Is Associated With Increased Rates of
Bone-Patellar Tendon-Bone Autograft Failure in Anterior Cruciate Ligament
Reconstructions Lazarides Alexander Leandros MD1Alentorn-Geli Eduard 2Vinson Emily MD2Samuelsson Kristian MD PhD MSc3Toth Alison P. MD4Moorman Claude T. MD4Garrett William E. MD, PhD5Taylor Dean C. MD41 Duke University Hospital Program,
Durham, NC, USA2 Duke University Medical Center, Durham,
NC, USA3 Sahlgrenska University Hospital,
Molndal, Sweden4 Duke University, Durham, NC, USA5 Duke Sport Sciences Institute, Durham,
NC, USA27 7 2018 7 2018 6 7 suppl4 2018 AOSSM Annual Meeting Abstracts2325967118S00142© The Author(s) 20182018SAGE PublicationsThis open-access article is published and distributed under the
Creative Commons Attribution - NonCommercial - No Derivatives License
(http://creativecommons.org/licenses/by-nc-nd/4.0/), which
permits the noncommercial use, distribution, and reproduction of the article
in any medium, provided the original author and source are credited. You may
not alter, transform, or build upon this article without the permission of
the Author(s). For article reuse guidelines, please visit SAGE’s website at
http://www.sagepub.com/journals-permissions.Objectives:
Revision ACL reconstruction can be potentially devastating for a patient. As
such, it is important to identify prognostic factors placing patients at
increased risk for re-rupture. There are no data on the effects of patellar
tendonopathy on failure of ACL reconstruction when using bone-patellar
tendon-bone (BPTB) autograft. The purpose of this study was to investigate
the effects of patellar tendinopathy on the risk of graft failure in primary
ACL reconstruction when using BPTB autograft.

Methods:
All patients undergoing ACL reconstruction at a single institution from 2005
to 2015 were examined. A total of 168 patients undergoing primary BPTB
autograft for primary ACL reconstruction were identified. Patient MRIs were
reviewed for the presence and grade of patellar tendinopathy by two
musculoskeletal fellowship-trained radiologists; both were blinded to the
aim of the study, patient demographics, surgical details and outcomes.
Patients were divided into two cohorts: failure and non-failure of the ACL
graft, defined as rupture of the ACL graft. Statistical analyses were run to
examine the role of patellar tendinopathy in failure of ACL reconstruction
using BPTB autograft.

Results:
At a mean follow up of 18 months, there were 7 (4.2%) patients with graft
failure. Moderate or high-grade patellar tendinopathy was associated with
ACL graft failure (p=0.011). Age, gender and side of reconstruction were not
associated with risk of re-rupture, though the majority of patients in our
study who failed were younger than 20 years of age. Use of patellar tendon
with moderate to severe tendinopathy was associated with a relative risk of
rupture of 6.1 as compared to autograft tendon without tendinopathy (95% CI
1.37-27.3).

Conclusion:
The presence of moderate or severe patellar tendinopathy significantly
increases the risk of graft failure when using BPTB autograft for primary
ACL reconstruction. Consideration of patellar tendinopathy should be made
when determining the optimal graft choice for patients undergoing primary
ACL reconstruction with autograft tendons.

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