Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
October 11, 2026 · via Europe PMC
Shorter Relative Patellar Defect Length After Bone-Patellar Tendon-Bone Autograft Anterior Cruciate Ligament Reconstruction Is associated With Better Postoperative Patient-Reported Outcomes at 1-Year Follow-Up.
Schroeder GG, Williams AA, Koltsov JCB, Wadsworth ALC, Acute ACL Team, Nelson BJ, Chu CR.
AI summary — for doctors, generated from the abstract only
Among 23 patients after bone-patellar tendon-bone ACL reconstruction, a shorter relative patellar defect at 6 weeks was associated with better 1-year KOOS scores.
What was studied
Case series of patients having patellar tendon autograft ACL reconstruction by one of 7 surgeons (June 2020 to June 2023), with knee MRI at 6 weeks and 1 year and KOOS at 1 year. Patellar bony defect dimensions relative to overall patellar size were measured and associated with outcomes.
Key findings
- 23 patients (15 men, mean age 25.5 years) were analyzed
- Shorter relative defect length at 6 weeks was associated with better KOOS activities of daily living (R2 = 0.481, P = .002) and sports and recreation (R2 = 0.436, P = .002)
- Pain (P = .078) and quality of life (P = .054) showed only trends, and longer defects were linked to kneeling difficulty (P = .020)
- Defect width and depth decreased from 6 weeks to 1 year; the p-value is cut off in the abstract
Clinical relevance
Surgeons might consider individual patellar size when deciding how much bone to harvest, since smaller relative defects tracked with better patient-reported function.
Who should care
Limitations
Very small sample (23) of a Level IV case series, association rather than causation, and no adjustment beyond age and sex. The abstract is truncated at the defect healing result, and the study cannot say whether changing harvest size would improve outcomes.
Smaller relative patellar defects were linked to better 1-year outcomes, but this small study cannot prove a harvesting strategy.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
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 (R2 = 0.481, P = .002) and function in sports and recreation (R2 = 0.436, P = .002), and showed trends for associating with better pain (R2 = 0.196, P = .078) and knee-related quality of life (R2 = 0.222, P = .054). Participants with longer relative defects were more likely to report difficulty with kneeling (R2 = 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 < .001), whereas relative defect length was unchanged. Intraobserver reliability was good to excellent for all measurements at 6 weeks and 1 year. Relative defect width and depth, at both 6 weeks and 1 year, had no significant associations with KOOSs at 1 year.
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.
DOI
10.1002/arj.70618
PMID
42860827
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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