Alteration of patellofemoral contact during healing of canine patellar tendon after removal of its central third

Alterations of the patellofemoral (PF) contact pressure and area were assessed using pressure-sensitive film after the removal of the central third of patellar tendon (PT) with healing over time in twelve dogs. The contralateral knee served as control. Histological sections were prepared for descriptive evaluation. No alterations in PT strain, PF contact pressure and area were measured immediately after the removal of the central third of PT compared with that before its removal. Compared with contralateral control, the healing of the donor PF induced a significantly increased PF contact area but not PF contact pressure in the specimens harvested at 6, 12, and 18 months after operation. Increased PF contact area indicated a proximal shift of the PF joint contact during flexion, which was associated with an increased strain of the healing PT under loading. The healing PT became hypertrophic compared with control, but the differences in the cross-sectional area were reduced over time. Histologically, a poorly organized extracellular matrix was observed at 6 months, with a progressive improvement in collagen fiber alignment up to 18 months postoperatively. The results of this study suggest that the removal of the central third of PT does not immediately change PF contact pressure and areas. However, remodeling of the healing tendon may cause an elongated PT, resulting in an increase in PF contact area under a given quadriceps force by knee extension.