Are pre-operative anthropometric parameters helpful in predicting length and thickness of quadrupled hamstring graft for ACL reconstruction in adults? A prospective study and literature review

Goyal, Saumitra; Matias, Nadia; Pandey, Vivek; Acharya, Kiran

doi:10.1007/s00264-015-2818-3

Cited by 67 publications

(93 citation statements)

References 23 publications

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“…2 Some of the authors have also proposed an equation for preoperative prediction of hamstring graft size. Tuman et al 9 and Treme et al 8 predicted an equation for expected graft diameter with patient's height being the sole variable.…”

Section: Discussionmentioning

confidence: 99%

“…This study was based on anthropometric measurements in Caucasian population. Goyal et al 2 used Figure 8. Correlation between observed and predicted quadrupled STG graft diameter in 300 patients in the second phase of the study.…”

Section: Discussionmentioning

confidence: 99%

“…anterior knee pain, kneeling discomfort) as compared to BPTB graft. 2,3 Availability of improved fixation devices like EndoButton and tight rope has also encouraged the use of hamstring graft. 4 However, there are concerns associated with the harvesting of STG graft.…”

Section: Introductionmentioning

confidence: 99%

“…5 Since graft strength is directly related to cross-sectional area of the graft, a minimum of 7 mm of graft diameter has traditionally been recommended for the success of ACL reconstruction. 2,6 Moreover, revision ACL surgeries pose a bigger challenge where a larger-diameter graft is required. 7 In such situations, preoperative prediction of graft dimensions can prove to be useful.…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have also suggested equations for the same, but none of the studies have done blinded verification of the equations being derived. 2,4,[6][7][8][9][10] Since tendinous structures show variability in people of different ethnicities and racial origins, 11 this being the only study deriving and verifying an equation based on anthropometric measurements in Indian population can prove useful in preoperative prediction of graft dimensions in Indian scenario.…”

Section: Introductionmentioning

confidence: 99%

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Equation-based precise prediction of length of hamstring tendons and quadrupled graft diameter by various anthropometric variables for knee ligament reconstruction in Indian population

Gupta

Malhotra

Masih

et al. 2017

J Orthop Surg (Hong Kong)

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Preoperative prediction of hamstring tendon lengths and graft diameter for anterior cruciate ligament (ACL) reconstruction enables better preoperative planning. Presently, no study exists for Indian population where both derivation and verification of a mathematical equation for accurate prediction of hamstring graft dimensions have been done. This study was conducted in two phases: First phase (derivation cohort): devoted to the study of correlation of length of hamstring tendons and graft diameter with various anthropometric measurements in 123 patients undergoing ACL reconstruction. Length of semitendinosus (ST) was observed to have a strong correlation with leg length (r ¼ 0.719), whereas that of gracilis (G) had a strong correlation with patient height (r ¼ 0.768). Quadrupled diameter (QD) had a strong correlation with patient height and thigh length (r ¼ 0.685 and 0.680, respectively). Using Pearson correlation coefficient, multiple stepwise linear regressions, and analysis of variance test, predictive equations were developed to predict the length of ST and G and QD. Second phase (verification cohort): This was a blinded prospective study done on 300 patients to further authenticate and test the accuracy of equations developed. Here, a steady correlation was found between the observed and predicted values of length of ST, G and QD, with correlation coefficients being 0.838, 0.847, and 0.767, respectively. Thus, we can safely conclude that clinically measurable anthropometric variables can reliably predict hamstring graft dimensions. This is likely to prove useful in better preoperative planning of ligament reconstructions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Equation-based precise prediction of length of hamstring tendons and quadrupled graft diameter by various anthropometric variables for knee ligament reconstruction in Indian population

Gupta

Malhotra

Masih

et al. 2017

J Orthop Surg (Hong Kong)

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Central femoral tunnel placement can reduce stress and strain around bone tunnels and graft more than anteromedial femoral tunnel in anterior cruciate ligament reconstruction

Cheng

Wang

Dimitriou

et al. 2022

Numer Methods Biomed Eng

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The present study investigated the effects of anteromedial (AM) and central femoral footprint placement on stress and strain distribution around the femoral and tibial tunnel and graft following anterior cruciate ligament reconstruction (ACLR). A three‐dimensional (3D) reconstructed knee model was validated and used for simulating ACLR by finite element analysis. A combined loading during normal human walking was applied to the knee models using different anatomic femoral tunnel placement at 20° knee flexion. The results of von Mises stress and principal strain at the entrances of the femoral and tibial tunnel and ACL graft was determined. The peak von Mises stress and the maximum principal strain in the AM footprint group were 8.78 MPa and 8850.89 μ‐strain at the entrance of femoral tunnel, and 5.29 MPa and 5553.27 μ‐strain at the entrance of tibial tunnel. The results in the AM footprint group were higher than that in the central footprint group. The peak von Mises stress around the ACL graft following AM footprint ACLR was 28.63 MPa, higher than that following the central footprint ACLR. The AM footprint ACLR generated more significant peak von Mises stress and maximum principal strain around the entrances of femoral and tibial tunnel and the graft than the central footprint. The present results are of clinical relevance as they can provide a better understanding of tunnel enlargement and graft failure.

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Tendon cross‐sectional area on magnetic resonance imaging and anthropometric characteristics can be used to predict insufficient four‐strand hamstring autograft diameter in anterior cruciate ligament reconstruction: A systematic review

Vivekanantha,

Grzela,

Wong

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeTo evaluate the utility of semitendinosus tendon (ST) and gracilis tendon (GT) cross‐sectional area (CSA) on magnetic resonance imaging (MRI) and anthropometric characteristics in preoperative estimation of graft diameter in patients undergoing anterior cruciate ligament reconstruction (ACLR) with four‐strand hamstring autografts.MethodsThree databases were searched on 29 August 2023. The authors adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) and R‐AMSTAR (Revised Assessment of Multiple Systematic Review) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Data on demographics, anthropometric characteristics, imaging techniques, tendon CSA, correlation coefficients, sensitivities, specificities, regression models and cutoffs for predicting intraoperative graft diameters above 8 mm were recorded.ResultsForty‐six studies comprising 4140 patients were included. Twelve of 19 (63.2%) studies reporting on ST + GT CSA found a moderate to very high correlation with intraoperative graft diameter. Five of 10 (50%) and one of seven (14.3%) studies reporting on ST CSA and GT CSA, respectively, found a moderate to high correlation with intraoperative graft diameter. Cutoffs of ST + GT CSA for predicting graft diameters above 8 mm ranged from 15.8 to 31.2 mm2. Nine of 35 (25.7%) studies that reported on height found a moderate to very high correlation with graft diameter. Seven of 33 (21.2%) studies reporting on weight found a moderate correlation with graft diameter.ConclusionOf the MRI parameters assessed, ST + GT CSA was the most reliable predictor of graft diameter. However, cutoffs, sensitivities, and specificities for predicting diameters above 8 mm were highly variable. Anthropometric characteristics in general were less predictive of graft diameter than MRI parameters. This information can be used by clinicians to predict patients at risk for ACLR failure due to insufficient graft size.Level of EvidenceLevel IV.

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Are pre-operative anthropometric parameters helpful in predicting length and thickness of quadrupled hamstring graft for ACL reconstruction in adults? A prospective study and literature review

Cited by 67 publications

References 23 publications

Equation-based precise prediction of length of hamstring tendons and quadrupled graft diameter by various anthropometric variables for knee ligament reconstruction in Indian population

Equation-based precise prediction of length of hamstring tendons and quadrupled graft diameter by various anthropometric variables for knee ligament reconstruction in Indian population

Central femoral tunnel placement can reduce stress and strain around bone tunnels and graft more than anteromedial femoral tunnel in anterior cruciate ligament reconstruction

Tendon cross‐sectional area on magnetic resonance imaging and anthropometric characteristics can be used to predict insufficient four‐strand hamstring autograft diameter in anterior cruciate ligament reconstruction: A systematic review

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