Background: Few studies have examined whether skeletal parameters predict hamstring graft size during anterior cruciate ligament reconstruction (ACLR).
Purpose/hypothesis: The purpose of this study was to examine whether preoperative anthropometric and radiographic skeletal parameters could predict hamstring graft size during ACLR. We hypothesized that both anthropometric and skeletal parameters can be used to predict graft size in our double-bundle procedure and that the use of skeletal parameters will improve the accuracy of graft size prediction.
Study design: Cross-sectional study; Level of evidence, 3.
Methods: A total of 200 patients were recruited and underwent double-bundle ACLR using a semitendinosus (ST) graft. The harvested tendon was measured to determine graft length (GL) and then split at its midpoint. The graft diameters of the anteromedial (GDAM) and posterolateral bundles (GDPL) were measured at the femoral aspect of the 2-stranded graft. The mean diameters of both bundles were included in the analysis. On the coronal radiograph, femorotibial angle (FTA), femoral interepicondylar distance (IED), and tibial plateau width (coronal tibial width [CTW]) were measured. Blumensaat line length (BLL) and the lateral tibial width (LTW) were measured on the lateral radiograph. A linear regression analysis was conducted using graft size as the dependent variable and age, sex, height, weight, Tegner activity score, and skeletal parameters as the independent variables.
Results: Mean GL was 258.9 ± 21.9 mm, GDAM was 5.9 ± 0.5 mm, and GDPL was 5.7 ± 0.6 mm. Single regression analysis showed that GL was significantly predicted by sex, height, weight, Tegner activity score, IED, CTW, BLL, and LTW (R2 range, 0.033-0.342). GD was predicted by sex, height, weight, IED, CTW, BLL, and LTW (R2 range, 0.094-0.207). Stepwise multiple linear regression analysis significantly confirmed sex, height, and age as the variables to comprehensively predict GL (R2 = 0.384). With regard to GD, stepwise multiple regression confirmed height and IED as significant variables (R2 = 0.224).
Conclusion: Both preoperative anthropometric and radiographic parameters on plain radiographs were able to predict harvested GL and 2-strand GD. Multivariate regression slightly improved the prediction of graft dimensions compared with univariate regression.
Keywords: anterior cruciate ligament reconstruction; graft size prediction; hamstring graft; skeletal structure.
Conflict of interest statement
The authors declared that they have no conflicts of interest in the authorship and publication of this contribution.
Prediction of the Graft Size of 4-stranded Semitendinosus Tendon and 4-stranded Gracilis Tendon for Anterior Cruciate Ligament Reconstruction: A Chinese Han Patient StudyG Xie et al. Am J Sports Med 40 (5), 1161-6. PMID 22307080.Several preoperative anthropometric measurements showed correlation with the length of the ST and GT and diameter of 4-stranded ST and GT grafts. The current data may pro …
Role of Anthropometric Data in the Prediction of 4-stranded Hamstring Graft Size in Anterior Cruciate Ligament ReconstructionSW Ho et al. Acta Orthop Belg 82 (1), 72-7. PMID 26984657.To evaluate whether pre-operative anthropometric data can predict the optimal diameter and length of hamstring tendon autograft for anterior cruciate ligament (ACL) recon …
Predictors for Hamstring Graft Diameter in Anterior Cruciate Ligament ReconstructionJM Tuman et al. Am J Sports Med 35 (11), 1945-9. PMID 17644660.Of the parameters studied, height was the best predictor of hamstring tendon diameter, particularly in women.
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Anterior Cruciate Ligament Reconstruction With a Four-Strand Hamstring Tendon Autograft. Surgical TechniqueRJ Williams 3rd et al. J Bone Joint Surg Am 87 Suppl 1 (Pt 1), 51-66. PMID 15743847. - ReviewReconstruction of the anterior cruciate ligament with use of a four-strand hamstring tendon autograft eliminated anterior tibial subluxation in 89% of patients who were e …
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A Meta-Analysis on Anterior Cruciate Ligament Reconstruction: Is Modified Transtibial Technique Inferior to Independent Drilling Techniques?Q Zhang et al. Exp Ther Med 16 (3), 1790-1799. PMID 30186403.This report respectively compared the standard transtibial (sTT) technique to the independent drilling (ID) techniques applied to anterior cruciate ligament (ACL) reconst …
Preoperative Sonographic Measurement Can Accurately Predict Quadrupled Hamstring Tendon Graft Diameter for ACL ReconstructionT Takenaga et al. Knee Surg Sports Traumatol Arthrosc 27 (3), 797-804. PMID 30167751.The diameter of 2ST and 4STG can be reliably predicted based on sonographic CSA measurement preoperatively. Sonography is a cost-effective alternate to repeat MRI to pred …
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