CONTRALATERAL PATELLAR TENDON AUTOGRAFT IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

LOBO JÚNIOR, PAULO; SANTOS NETO, EUGÊNIO DOS; BORGES, JOSÉ HUMBERTO DE SOUZA; DIAS, LUANA JUNQUEIRA RESENDE VOLPE; MACHADO, RONNY DE SOUZA; FREITAS, ANDERSON

doi:10.1590/1413-785220182602185594

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REVIEW ARTICLE, KNEE • Acta ortop. bras. 26 (2) • Mar-Apr 2018 • https://doi.org/10.1590/1413-785220182602185594 linkcopy

CONTRALATERAL PATELLAR TENDON AUTOGRAFT IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

TENDÃO PATELAR CONTRALATERAL COMO ENXERTO EM RECONSTRUÇÃO DO LIGAMENTO CRUZADO ANTERIOR

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To conduct a systematic review of literature about the use of contralateral patellar tendon autograft in anterior cruciate ligament reconstructions and present the results.

Methods: The LILACS, MEDLINE, Cochrane, PubMed, Scielo and Google Scholar databases were searched without date restrictions for the keywords “anterior cruciate ligament reconstruction” combined with “contralateral” in the article title. After the studies were identified, two independent evaluators collected the qualitative characteristics of the studies and classified them according to clinical outcomes of these grafts as positive, neutral, or negative.

Results: A total of 755 articles were found initially, and after detailed evaluation of all references, followed by a screening process and assessment of quality, a total of 11 studies were determined to be eligible for inclusion in this systematic review. Of these, 72.72% were level II studies, the most common level of evidence among the results. Positive results for this type of graft were found in 63.63% of the studies.

Conclusion: Based on the literature review, most of the included articles (63.63%) presented positive results for the use of contralateral patellar tendon grafts. Level of Evidence III; Systematic review.

Keywords:
Anterior cruciate ligament; Patellar ligament; Knee joint; Tendons/transplantation

Database	Number of articles
Pubmed	22
Bireme	557
Lilacs	26
Google Scholar	68
Cochrane	67
Scielo	15
Total	755

Reference	Title	Conclusion	Level of Evidence	Result
Rubinstein et al.⁵, 1994.	Isolated autogenous bone-patellar tendon-bone graft site morbidity	The morbidity from collecting contralateral patellar tendon grafts seems to be of short duration and largely reversible.	2C	P
Uribe et al.⁶, 1996.	Revision anterior cruciate ligament surgery: experience from Miami.	Collection of the contralateral patellar tendon was not found to produce adverse effects in the long term. Learning several anterior cruciate ligament reconstruction techniques and avoiding tunnels and pre-existing implants facilitate surgical revision. Correct placement of the graft and addressing secondary constraints are essential for a successful revision surgery.	2C	I
Kartus et al.⁹, 1998.	Ipsi- or contralateral patellar tendon graft in anterior cruciate ligament revision surgery. A comparison of two methods.	Recovery after anterior cruciate ligament reconstruction using the ipsilateral patellar tendon resulted in lower functional scores and a greater rate of complications than revision with the contralateral patellar tendon.	2B.	P
Bruck et al.¹⁰,1998.	Morbidity after contralateral transplantation of the patellar ligament for cruciate ligament replacement	There was no radiographic evidence of low patella. Use of contralateral patellar tendon graft for anterior cruciate ligament reconstruction does not involve severe morbidity.	2C	P
Shelbourne et al.¹¹, 2000.	Primary anterior cruciate ligament reconstruction using the contralateral autogenous patellar tendon.	The contralateral patellar tendon may be used to restore range of motion and muscle strength earlier than ipsilateral patellar tendon graft. Patients may also return to full capacity in sports more quickly without compromising maximum stability.	2A	P
Shelbourne et al.¹², 2005.	Contralateral patellar tendon and the Shelbourne experience Part 2. Results of Revision Anterior Cruciate Ligament Reconstruction	The objectives of ACL reconstruction revision should be similar to those of primary surgery, restoring stability, movement, and function. Suggests using the contralateral patellar tendon graft and mini-arthrotomy technique Provides similar results to the primary procedure and has consequently become the method of choice for primary ACL reconstruction.	2B	P
Zink et al.¹³, 2005.	Gender comparison of knee strength recovery following ACL reconstruction with contralateral patellar tendon graft.	Since strength recovery after surgery is not identical in men and women, specific rehabilitation protocols for each sex may be justified.	2C	I
Mastrokalos et al.¹⁴, 2005.	Donor site morbidity and return to the preinjury activity level after anterior cruciate ligament reconstruction using ipsilateral and contralateral patellar tendon autograft: a retrospective, nonrandomized study	Contralateral patellar tendon graft appears to offer no advantages over ipsilateral grafts, because all symptoms related to morbidity of the donor site are transferred to the healthy knee, and patients do not return to activity earlier.	2A	N
Benner et al.¹⁵, 2011.	Infections and patellar tendon ruptures after anterior cruciate ligament reconstruction A comparison of ipsilateral and contralateral patellar tendon autografts	There were no significant differences in the incidence of infection or patellar tendon rupture between the ipsilateral and contralateral groups. Patients with complications after ACL reconstruction using an autogenous patellar tendon graft may have less difficulty achieving complete knee movement when the graft is collected from the contralateral knee.	3A	P
Dauty et al.¹⁶, 2014.	Muscular isokinetic strength recovery after knee anterior cruciate ligament reconstruction revision: Preliminary study	Deficits in isokinetic muscle strength after ACL revision seem similar to those observed after primary ACL reconstruction using the same surgical technique and patellar, ipsilateral ischiotibial, and contralateral patellar grafts.	3A	I
Shelbourne et al.¹⁷, 2015.	Anterior cruciate ligament reconstruction with contralateral autogenous patellar tendon graft: evaluation of donor site strength and subjective results.	After ACL reconstruction using a contralateral patellar graft, patients can achieve symmetrical force in the legs without adverse subjective symptoms after graft collection. Additionally, there may be more return with a contralateral graft than with an ipsilateral graft.	3A	P

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