Multiple studies found hamstring tendon (HT) autograft diameter to be a risk factor for anterior cruciate ligament (ACL) reconstruction failure. This study aimed to determine which preoperative measurements are associated with HT autograft diameter in ACL reconstruction by directly comparing patient characteristics and cross-sectional area (CSA) measurement of the semitendinosus and gracilis tendon on magnetic resonance imaging (MRI). Fifty-three patients with a primary ACL reconstruction with a four-stranded HT autograft were included in this study. Preoperatively we recorded length, weight, thigh circumference, gender, age, preinjury Tegner activity score, and CSA of the semitendinosus and gracilis tendon on MRI. Total CSA on MRI, weight, height, gender, and thigh circumference were all significantly correlated with HT autograft diameter (p < 0.05). A multiple linear regression model with CSA measurement of the HTs on MRI, weight, and height showed the most explained variance of HT autograft diameter (adjusted R 2 = 44%). A regression equation was derived for an estimation of the expected intraoperative HT autograft diameter: 1.2508 + 0.0400 × total CSA (mm2) + 0.0100 × weight (kg) + 0.0296 × length (cm). The Bland and Altman analysis indicated a 95% limit of agreement of ± 1.14 mm and an error correlation of r = 0.47. Smaller CSA of the semitendinosus and gracilis tendon on MRI, shorter stature, lower weight, smaller thigh circumference, and female gender are associated with a smaller four-stranded HT autograft diameter in ACL reconstruction. Multiple linear regression analysis indicated that the combination of MRI CSA measurement, weight, and height is the strongest predictor.

The Doha agreement classification is used to classify groin pain in athletes. We evaluated the inter‐examiner reliability of this classification system. We prospectively recruited 48 male athletes (66 symptomatic sides) with groin pain between 10–2017 and 03–2020 at a sports medicine hospital in Qatar. Two examiners (23 and 10 years of clinical experience) performed history taking, and a standardized clinical examination blinded to each other's findings. Examiners classified groin pain using the Doha agreement terminology (adductor‐, inguinal‐, iliopsoas‐, pubic‐, hip‐related groin pain, or other causes of groin pain). Multiple entities were ranked in order of perceived clinical importance. Each side was classified separately for bilateral groin pain. Inter‐examiner reliability was calculated using Cohen's Kappa statistic ( κ ). Inter‐examiner reliability was slight to moderate for adductor‐ ( κ = 0.40), inguinal‐ ( κ = 0.44), iliopsoas‐ ( κ = 0.57), and pubic‐related groin pain ( κ = 0.12), substantial for hip‐related groin pain ( κ = 0.62), and slight for “other causes of groin pain” ( κ = 0.13). Ranking entities in order of perceived clinical importance improved inter‐examiner reliability for adductor‐, inguinal‐, and iliopsoas‐related groin pain ( κ = 0.52–0.65), but not for pubic ( κ = 0.12), hip ( κ = 0.51), and “other causes of groin pain” ( κ = 0.03). For participants with unilateral groin pain classified with a single entity ( n = 7), there was 100% agreement between the two examiners. Inter‐examiner reliability of the Doha agreement meeting classification system varied from slight to substantial, depending on the clinical entity. Agreement between examiners was perfect when athletes were classified with a single clinical entity of groin pain, but lower when athletes were classified with multiple clinical entities.