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ANTERIOR KNEE PAIN IN AN ANTERIOR CRUCIATE DEFICIENT KNEE IS PRESENT PRIOR TO RECONSTRUCTION

Orthopaedic Department, Mail Point 45, Southampton General Hospital, Tremona Road, Southampton, Hampshire, SO16 6YD

There is a recognised incidence of anterior knee pain following Anterior Cruciate Ligament (ACL) reconstruction using a patella tendon autograft.

This study examined two group of patients both pre ACL ligament reconstruction and post ACL reconstruction using patella tendon grafts to define if anterior knee pain is a result of patella tendon harvest or a primary consequence of an ACL injury.

The two groups of patients were best matched for age, sex and physical activity.

The pre-operative group of twenty-five patients had a confirmed ACL rupture and exhibited symptoms of instability requiring an ACL reconstruction.

The operative group of twenty-five patients were a minimum of a year post operation.

The graft was harvested by an open procedure and the graft bone blocks were secured with interference screws.

The patients’ anterior knee pain score was assessed using the Shelbourne scoring system that evaluates knee function in relation to anterior knee pain using five parameters. The maximum score is 100.

The scores were compared using the unpaired student test.

There was no significant age difference between the two groups, preoperative group age 32. 2 years (range 22 to 46) and postoperative age 34. 8years (range 19 to 48).

The mean anterior knee pain score for the preoperative group was 71. 6 (49 to 100), the postoperative group was 77. 7 (45 to 100), this was not significantly different.

We found no significant difference in knee function due to anterior knee pain between the two groups. Studies have shown significant anterior knee pain following hamstring reconstruction (Spicer).

This study shows anterior knee pain in the ACL deficient knee is present prior to surgery.

We conclude that patella tendon autografts produce no significant incidence of anterior knee pain post surgery.

The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom