Sampling of free transplant bone-tendon-bone by mini-invasive way or by conventional way: prospective and comparative study of 36 cases

Abstract

The study has been carried out at the Emile de Vialar Clinic in Lyon (France) The aim of that study is to analyze the feasibility of the mini invasive technique through a comparative and prospective study uni-centric realized on two groups: “classical” and “mini-invasive” of 18 patients. The patients have been checked 6 to 8 months after the surgery. Check has been clinical, radiological and echographycal. Radiological laxity has been evaluated for each compartment. The echographycal study analyzed the the patellar tendon and peri tendon. All data were extracted on an Excel spreadsheet (Microsoft) and analyzed with spreadsheet tools and those of the toolbox Statistical Toolbox (Matlab). A radiological classification of the anterior tibial tuberosity (TTA) was established. The study highlights a correlation between the TTA and the patellar apex. The grafts taken by classical technique showed in every case good characteristic, against 45% of cases taken by «miniinvasive way". The earlier pain was 22 % in the "classic" group and 33% in «mini-invasive». Data analysis showed no correlation between the earlier pain and (a) the result of “knee walking” test or (b) the thickness of the peri- tendon. It was found a correlation between the results of «knee walking» test and the asymmetry of tabs width in the "mini-invasive" group. The IKDC scores: a) Subjective was virtually identical and b) Objective was 94% (or A) to the "classic" group and 81% (A or B) to the group "mini- invasive". This “mini- invasive" technique respects the infra- patellar branch of intern saphenous nerve in 95%. The indication of sampling patellar graft by “mini invasive” technique is the TTA type III.