Can we predict the size of frequently used autografts in ACL reconstruction?

Zakko, Philip; Eck, Carola F. van; Guenther, Daniel; Irrgang, James J.; Fu, Freddie H.

doi:10.1007/s00167-015-3695-4

Cited by 38 publications

(52 citation statements)

References 39 publications

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“…It has been suggested that detailed preoperative planning helps to determine the most appropriate graft for ACL reconstruction and the ability to preoperatively template the appropriate graft size will minimize graftetunnel mismatch. 20,21,28,29 Factors that influence graft choice include bone morphology, size of the intercondylar notch, and the tibial and femoral footprints of the ACL. 28 Two common grafts that frequently are used are HS and BPTB grafts, and excellent results can be obtained with both if surgical techniques are consistently applied.…”

Section: Discussionmentioning

confidence: 99%

The Association Between Anterior Cruciate Ligament Length and Femoral Epicondylar Width Measured on Preoperative Magnetic Resonance Imaging or Radiograph

Zyl

Schoor

Toit

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To determine whether femoral epicondylar width (FECW) obtained from either magnetic resonance imaging (MRI) or plain radiographs could be used to predict anterior cruciate ligament (ACL) length. A secondary purpose was to develop a formula to use maximum FECW on either MRI or plain radiographs to estimate ACL length preoperatively. Methods: The MRIs and radiographs of 40 patients (mean age 41.0 years), with no apparent knee pathology, surgery, or trauma were included. The ACL length was measured on MRI followed by FECW on both MRI and radiograph of the same patient. This allowed the development of equations able to predict ACL length according to the FECW measured on either an MRI or radiograph. Results: The mean ACL length was 40.6 AE 3.6 mm. FECW measured on both MRIs and radiographs was sufficient to predict ACL length. Pearson's correlations revealed a high positive relationship between ACL length and FECW on MRI (r ¼ 0.89, P < .0001) and ACL length and FECW on radiograph (r ¼ 0.83, P < .0001). The coefficient of determination (R 2) was calculated to be MRI: R 2 ¼ 0.78 and radiograph: R 2 ¼ 0.68 and confirmed that FECW measured on both MRI and radiograph were sufficient to predict ACL length. Based on these models, ACL length can be predicted by FECW using the following formulas: MRI: ACL length ¼ 0.47 (FECW) þ 1.93 and radiograph: ACL length ¼ 0.31 (FECW) þ 11.33. Conclusions: This study demonstrated that FECW measured on either MRI or anteroposterior radiograph could reliably estimate ACL length on a sagittal MRI. There was a high positive relationship between ACL length and FECW on both MRI and radiographs, although MRIs do predict ACL length more reliably. Clinical Relevance: Preoperative ACL length assessment, using FECW on MRI or radiograph, is useful in graft selection and in preventing inadequate graft harvesting for ACL reconstruction, especially if an individualized anatomical approach is pursued.

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Section: Discussionmentioning

confidence: 99%

The Association Between Anterior Cruciate Ligament Length and Femoral Epicondylar Width Measured on Preoperative Magnetic Resonance Imaging or Radiograph

Zyl

Schoor

Toit

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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“…In a recent study on 62 patients that underwent ACL surgery, Zakko et al observed that preoperative MRI measurements of QT, PT and hamstring graft size are highly reliable with moderate-to-good accuracy. Further, a significant correlation between patient anthropometric data and the thicknesses of both QT and PT was observed 18 . Our results are consistent with previous MRI studies demonstrating weakly positive correlations between QT thickness and anthropometric data.…”

Section: Ns=no Significant Differencesmentioning

confidence: 94%

“…PT thickness was measured three times, respectively 1 cm below the lower border of the patella (P1), at the middle of the patellar tendon (P2) and 1 cm above the upper border of the tibial tubercle portion (P3), respectively, as described by Chang et al 14 . QT was measured at three levels, at distances of 10 (Q1), 20 (Q2) and 30 mm (Q3) from the superior pole of the patella 18 (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

MRI evaluation to predict tendon size for knee ligament reconstruction

Grassedonio

Albano

Galia

et al. 2017

MLTJ

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SummaryBackground: The aim of this study is to evaluate a possible correlation between specific anthropometric parameters and sizes of knee tendons commonly used for ACL reconstruction. We hypothesized that specific clinical and radiological knee measurements could be better tendon sizes predictors than age, gender, height and weight. Materials and methods: 100 consecutive patients were enrolled and 77 patients met the inclusion criteria of the study. All patients underwent a MRI of the knee with a 1.5 T super conducting MR System. For each patient, anthropometric data such as gender, height, weight, body mass index (BMI) and knee circumference were recorded. Specific MRI knee measurements were performed on each study: patellar tendon (PT) thickness and length, quadriceps tendon (QT) thickness, semitendinosus tendon (ST) diameter, gracilis tendon (GR) diameter, the largest patella and intercondylar width. Results: The mean ST diameter, QT thickness and PT thickness were higher in males than in females. No significant differences were noted between males and females concerning GT diameter and the knee circumference. In addition, male knees had greater patellar and intercondylar width than female knees. Significant, but only weak correlations were found between patient anthropometric data and hamstrings diameter, PT length, and QT and PT thickness. Intercondylar and patellar width present a moderate correlation between PT thickness, PT length and ST diameter. Conclusion:The intercondylar and patellar width presented a moderate correlation with PT thickness, PT length and ST diameter. Further, weak correlations were found between patient anthropometric data (gender, weight, height, BMI) and GR and ST diameter, PT length, and QT and PT thickness. This results may help surgeons during preoperative planning, specifically regarding graft choice and size. Level of evidence: III.

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“…Specifically, patellar tendon length was measured from the posterior insertion of the tendon to the tibia to the posterior insertion of the tendon to the patella. PT thickness was measured three times, respectively 1 cm below the lower border of the patella (P1), at the middle of the patellar tendon (P2) and 1 cm above the upper border of the tibial tubercle portion (P3), respectively, as described by Chang et al 14 . QT was measured at three levels, at distances of 10 (Q1), 20 (Q2) and 30 mm (Q3) from the superior pole of the patella 18 (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

MRI evaluation to predict tendon size for knee ligament reconstruction

Albano

Galia

D’Arienzo³

et al. 2019

Muscle Ligaments and Tendons J

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Background:The aim of this study is to evaluate a possible correlation between specific anthropometric parameters and sizes of knee tendons commonly used for ACL reconstruction. We hypothesized that specific clinical and radiological knee measurements could be better tendon sizes predictors than age, gender, height and weight. Materials and methods: 100 consecutive patients were enrolled and 77 patients met the inclusion criteria of the study. All patients underwent a MRI of the knee with a 1.5 T super conducting MR System. For each patient, anthropometric data such as gender, height, weight, body mass index (BMI) and knee circumference were recorded. Specific MRI knee measurements were performed on each study: patellar tendon (PT) thickness and length, quadriceps tendon (QT) thickness, semitendinosus tendon (ST) diameter, gracilis tendon (GR) diameter, the largest patella and intercondylar width. Results: The mean ST diameter, QT thickness and PT thickness were higher in males than in females. No significant differences were noted between males and females concerning GT diameter and the knee circumference. In addition, male knees had greater patellar and intercondylar width than female knees. Significant, but only weak correlations were found between patient anthropometric data and hamstrings diameter, PT length, and QT and PT thickness. Intercondylar and patellar width present a moderate correlation between PT thickness, PT length and ST diameter. Conclusion: The intercondylar and patellar width presented a moderate correlation with PT thickness, PT length and ST diameter. Further, weak correlations were found between patient anthropometric data (gender, weight, height, BMI) and GR and ST diameter, PT length, and QT and PT thickness. This results may help surgeons during preoperative planning, specifically regarding graft choice and size. Level of evidence: III.

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Can we predict the size of frequently used autografts in ACL reconstruction?

Abstract: III.

Cited by 38 publications

References 39 publications

The Association Between Anterior Cruciate Ligament Length and Femoral Epicondylar Width Measured on Preoperative Magnetic Resonance Imaging or Radiograph

The Association Between Anterior Cruciate Ligament Length and Femoral Epicondylar Width Measured on Preoperative Magnetic Resonance Imaging or Radiograph

MRI evaluation to predict tendon size for knee ligament reconstruction

MRI evaluation to predict tendon size for knee ligament reconstruction

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