title: Insall-Salvati ratio after arthroscopic anterior cruciate ligament reconstruction with patellar tendon graft.
abstract: BACKGROUND
  Arthroscopic anterior cruciate ligament (ACL) reconstruction with patellar tendon graft has been considered to be the gold standard treatment of anterior cruciate ligament injuries. Much morbidity could occur after this graft was harvested, such as the patellar tendon length change and anterior knee pain. Insall-Salvati ratio is one of the tools to determine the patella tendon length.
  
  
  OBJECTIVE
  To study the patella tendon length change after arthroscopic ACL reconstruction with patellar tendon graft by using Insall-Salvati ratio.
  
  
  METHODS
  Descriptive study was conducted. Patients who were diagnosed ACL injury and underwent arthroscopic ACL reconstruction with patellar tendon graft were included. All patients had standardized preoperative and postoperative lateral knee radiographs. The patellar tendon length, patellar height, Insall-Salvati ratio and Tegner Lysholm knee score were measured by the same person for all subjects at preoperative and 6 months postoperative period.
  
  
  RESULTS
  In a series of 22 patients, the length of the patellar tendon lengthened by an average of 0.95 mm (6 mm shortening to 5 mm lengthening) or 1.82% and not statistically significant (p = 0.101). The Insall-Salvati ratio increased by 2.75% (16.32% shortening to 18.6% lengthening) which was also not statistically significant (p = 0.218). The Tegner Lysholm knee score was improved to 20.36 (5 to 45), which was statistically significant (p < 0.05). The amount of the Insall-Salvati ratio change was not related to Lysholm score (p = 0.571).
  
  
  CONCLUSIONS
  The present study indicated that there was no significant change of patellar tendon length after arthroscopic ACL reconstruction with patellar tendon graft. No correlations with postoperative Insall-Salvati ratio and Tegner Lysholm knee score, however, the clinical results was improved in all of the patients.
authors: Department of Orthopaedics, Phramongkutklao Army Hospital, Bangkok, Thailand. nwrbl@yahoo.com
authors: Nitis
authors: N
authors: Reeboonlap
authors: Chalat
authors: C
authors: Naksongsak
authors: Korakot
authors: K
authors: Charakorn
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods; D001182:Arthroscopy; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D017847:Patellar Ligament / Q000033:anatomy & histology* / Q000637:transplantation*; D012421:Rupture; D055815:Young Adult