✅ Knee MRI Mastery/Chap 2.ACL and PCL

(Fig 2-C.02) Bone-patellar tendon-bone (BPTB) autograft -1

MSK MRI 2024. 3. 2. 07:55

https://youtu.be/ucPGY9r0cv8

https://youtu.be/uDgqFi3itg0

Bone-Patellar Tendon-Bone (BPTB) Autograft

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1️⃣ Optimal Patient

  • Age: Less than 35 years old
  • Engaged in high-level pivoting sports with high physical demand

2️⃣ Advantages

  • Bone-to-bone healing potentially leads to more aggressive rehabilitation
  • Low graft rupture rates comparable to quadruple hamstring tendon (QT) grafts
  • High return to sport rates

3️⃣ Disadvantages

  • Highest rate of donor site morbidity and anterior knee pain
  • Higher rates of osteoarthritis (OA) progression
  • Risk of patellar fracture or patella tendon rupture
  • Not suitable for skeletally immature patients
  • Possible higher risk of contralateral ACL rupture
  • Decreased extensor strength

4️⃣ Procedure

  • Harvested from the central third of the patellar tendon with bone grafts from the inferior pole of the patella and tibial tuberosity
  • Bone grafts initially anchored within the tunnels using interference screws
  • Achieves deeper fixation through bone-to-bone healing, known to occur as early as 16 weeks following surgery

 

✅ Screw and Washer

  • Greater length required to ensure sufficient graft length along the interference screw
  • Adequate length necessary for proper fixation and stability
  • Additional length required when using a spiked ligament screw washer on the tibial cortex
  • Graft must extend out of the tibial tunnel to accommodate the washer

 

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