Background

Bone-patellar tendon-bone (BPTB) anterior cruciate ligament (ACL) reconstruction is the most frequently used technique but has been associated with 25-60% incidence of anterior knee pain. These studies fail to evaluate if this is functional knee pain, defined as a pain that limits the patient’s ability to return to their prior level of activity or sport.

Hypothesis/Purpose:
To determine the incidence of functional knee pain after BPTB ACL reconstruction.

Study Design: Prospective Case Series

Methods

BPTB ACL reconstructions were reviewed from 2013-2017. Those with 1-year clinical follow-up completed a questionnaire evaluating the presence of anterior knee pain and their ability to return to sport/activities, as well as IKDC, Lysholm, and KOOS scores.

Results

A total of 66 patients were included. Anterior knee pain was highest at the 3-month time point, with an incidence of 15.2%. Anterior knee pain was present in 40.9%, but this pain was not functionally limiting in any patient. Overall, 98.5% of patients returned to activity/sport. VAS pain scores decreased from 1.66 to 0.11 over the first year. At final follow-up, average outcome scores were: IKDC 82.8, Lysholm, 87.0, KOOS: Symptoms 82.1, Pain 90.6, ADL 98.5, Sports 85.0, and QOL (75.0).

Conclusion

This is the first study to report ACL reconstruction with BPTB autograft does not cause functional anterior knee pain, as no patients were limited in their activities from anterior knee pain.

What this study adds to existing knowledge:
This study demonstrates that, despite a reported incidence of anterior knee pain consistent with the current literature, this pain does not limit the patient’s/athlete’s ability to return to their prior level of activity/sport.