The purpose of this study was to measure the effect of bone–patellar tendon–bone autograft harvest for anterior cruciate ligament (ACL) reconstruction on the surface strain of the human patella. Through progressive removal of bone from the patella, three different defect shapes as well as the intact patella were tested in each of seven knees. Maximum principal strain and corresponding principal direction were determined from each of three gages around the defect for the four conditions (intact plus three defect shapes). There were no statistically significant differences in overall average surface strain between any of the defect shapes. Following graft harvest, overall average strain (all three defects combined) increased in the patella both medial (15 percent increase) and lateral (34 percent increase) to the defect, while decreasing in the region directly proximal (22 percent increase) to the harvest site compared to the intact patella. A statistically significant 7.5 deg shift of principal direction from longitudinal toward a more transverse (lateral-superior to medial-inferior) direction was observed in the medial region when a shallow-dome defect was made. We conclude that removal of a bone block from the anterior, inferior part of the patella induces a significant redistribution of the surface strain. This results in greater local strain adjacent to the upper border of the bone block, increasing the risk for patella fracture. This effect may be of importance in various complications known to occur after ACL reconstruction.
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April 1999
Research Papers
Harvest of Patellar Tendon (Bone–Tendon–Bone) Autograft for ACL Reconstruction Significantly Alters Surface Strain in the Human Patella
H. Steen,
H. Steen
Biomechanics Lab, National Hospital, Orthopaedic Center, University of Oslo, Oslo, Norway; Orthopaedic Research Laboratories, University of Michigan, Ann Arbor, MI 48106
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K.-F. Tseng,
K.-F. Tseng
Orthopaedic Research Laboratories, University of Michigan, Ann Arbor, MI 48106
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S. A. Goldstein,
S. A. Goldstein
Orthopaedic Research Laboratories, University of Michigan, Ann Arbor, MI 48106
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J. E. Carpenter
J. E. Carpenter
Orthopaedic Research Laboratories, University of Michigan, Ann Arbor, MI 48106
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H. Steen
Biomechanics Lab, National Hospital, Orthopaedic Center, University of Oslo, Oslo, Norway; Orthopaedic Research Laboratories, University of Michigan, Ann Arbor, MI 48106
K.-F. Tseng
Orthopaedic Research Laboratories, University of Michigan, Ann Arbor, MI 48106
S. A. Goldstein
Orthopaedic Research Laboratories, University of Michigan, Ann Arbor, MI 48106
J. E. Carpenter
Orthopaedic Research Laboratories, University of Michigan, Ann Arbor, MI 48106
J Biomech Eng. Apr 1999, 121(2): 229-233 (5 pages)
Published Online: April 1, 1999
Article history
Received:
June 20, 1997
Revised:
October 26, 1998
Online:
January 23, 2008
Citation
Steen, H., Tseng, K., Goldstein, S. A., and Carpenter, J. E. (April 1, 1999). "Harvest of Patellar Tendon (Bone–Tendon–Bone) Autograft for ACL Reconstruction Significantly Alters Surface Strain in the Human Patella." ASME. J Biomech Eng. April 1999; 121(2): 229–233. https://doi.org/10.1115/1.2835108
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