title: Infections and patellar tendon ruptures after anterior cruciate ligament reconstruction: a comparison of ipsilateral and contralateral patellar tendon autografts.
abstract: BACKGROUND
  No studies document the incidence or results of infections and patellar tendon ruptures after anterior cruciate ligament reconstruction with a contralateral patellar tendon autograft.
  
  
  OBJECTIVE
  To determine the results of patients who have infections and patellar tendon ruptures after anterior cruciate ligament reconstruction with a patellar tendon autograft and compare the results between ipsilateral and contralateral grafts.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  The authors determined the incidence of infections requiring surgical intervention and complete patellar tendon ruptures after surgery. Data were analyzed in 2 groups based on the graft source: ipsilateral (n = 2553) or contralateral (n = 2811). Data reviewed included range of motion, quadriceps strength, and subjective evaluations.
  
  
  RESULTS
  Infections occurred in 9 ipsilateral patients (0.35%) and 4 contralateral patients (0.14%) (P = .12). At final follow-up, less than normal knee extension was found in 4 ipsilateral patients and 1 contralateral patient; less than normal flexion was found in 4 ipsilateral patients and 2 contralateral patients. Patellar tendon ruptures occurred in 6 ipsilateral patients (0.24%) and 7 contralateral patients (0.25%) (P = .92). At 1 month after patellar tendon repair, mean motion (degree of hyperextension-degree short of 0° extension-degree of flexion) in the contralateral group was 5-0-137 in the reconstructed knee and 5-0-118 in the graft-donor knee, which was greater than 5-0-98 found in the ipsilateral group for the reconstructed knee (P < .05). The mean Noyes subjective score at a mean of 4 years postoperatively for the tendon-ruptured knee was 87 points in the ipsilateral group and 93 points in the contralateral group (P = .32), which is comparable with the published normative data for the Noyes score reporting a mean score of 93.6 ± 8.3 points.
  
  
  CONCLUSIONS
  There were no significant differences in the incidence of infection or patellar tendon rupture between the ipsilateral and contralateral groups. Patients with complications after anterior cruciate ligament reconstruction with a patellar tendon autograft may have less difficulty obtaining full knee motion when the graft is harvested from the contralateral knee.
authors.affiliation: Shelbourne Knee Center, 1815 N Capitol Avenue, Indianapolis, IN 46202, USA. tgray@aclmd.com
authors.forename: Rodney W
authors.initials: RW
authors.lastname: Benner
authors.forename: K Donald
authors.initials: KD
authors.lastname: Shelbourne
authors.forename: Heather
authors.initials: H
authors.lastname: Freeman
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D017847:Patellar Ligament / Q000293:injuries* / Q000637:transplantation*; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012421:Rupture / Q000601:surgery; D013530:Surgical Wound Infection / Q000209:etiology* / Q000601:surgery; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult