Anterior cruciate ligament (ACL) reconstruction is one of the most common surgical procedures in orthopedics. Although multiple graft options are available, the use of allograft tissue is increasing in popularity to reduce postoperative pain and peri-operative morbidity associated with autograft harvest. One potential problem specific to patellar tendon grafts during endoscopic ACL reconstructions is the possibility of graft-tunnel mismatch. This occurs when the relative length of the bone-tendon-bone (BTB) construct exceeds the combined length of the femoral tunnel, intra-articular ACL distance, and tibial tunnel length, resulting in extrusion of the tibial plug. It is specific to endoscopic ACL reconstruction with BTB autograft and allograft and not encountered with the 2-incision ACL reconstruction technique. Renewed interest in anatomic ACL reconstruction has led to an increase in femoral tunnel drilling through an accessory medial portal.

Some recent research indicates that this may result in shorter femoral tunnel lengths and intra-articular distances, thereby increasing the chances of graft-tunnel mismatch. If inadequate bone from the tibial plug lies within the tibial tunnel, fixation of the graft may be compromised.

The purpose of this study by Dr. Verma and his team was to valuate whether a correlation exists between patient height and soft-tissue patellar tendon length through magnetic resonance imaging (MRI).

Full Article: Avoiding Mismatch in Allograft Anterior Cruciate Ligament Reconstruction: Correlation Between Patient Height and Patellar Tendon Length