Correlation between anthropometric measurements and graft size in anterior cruciate ligament reconstruction: a systematic review and meta-analysis

Abstract

Purpose This systematic review and meta-analysis aimed to investigate the correlation between anthropometric measurements and graft size in anterior cruciate ligament (ACL) reconstruction. Methods A systematic search of Ovid MEDLINE, Embase, and Cochrane Library databases was conducted for observational studies published until March 2023 that reported the relationship between anthropometric data [height, weight, body mass index (BMI), age, gender, thigh length, and circumference] and ACL graft size. Correlation coefficients (COR) and their associated 95% confidence intervals were used as the primary effect size. This review was conducted in line with PRISMA guidelines. Results A total of 42 observational studies involving 7110 patients were included, with a mean age of 29.8 years. Statistically significant, moderately positive correlations were found between graft size and height (COR: 0.49; 95% CI: 0.41–0.57; p-value: < 0.001), weight (COR: 0.38; 95% CI: 0.31–0.44; p-value: < 0.001), thigh circumference (COR: 0.40; 95% CI: 0.19–0.58; p-value: < 0.001), and thigh length (COR: 0.35; 95% CI: 0.18–0.50; p-value: < 0.001). However, age and gender were insignificantly correlated with graft size (p-value: NS). A subanalysis based on graft type showed a significant positive correlation between height and graft diameter, which was more significant in the peroneus tendon than in hamstring grafts (COR: 0.76 vs. 0.45; p-value: 0.020). Conclusion This study demonstrated a moderate positive correlation between anthropometric measurements (height, weight, thigh circumference, and length) and ACL graft size, along with a weak positive correlation with BMI. Age and gender showed no significant correlation. These findings support the predictability and selection of ACL graft size based on pre-operative patient anthropometric data. Level of evidence Level of Evidence: IV. PROSPERO registration number: CRD42023416044.

Correlation of Hamstring Tendon Size in Pre-Operative MRI Measurement with Intra-Operative Graft Size in Primary Anterior Cruciate Ligament (ACL) Reconstruction

“…A study done by Salman et al [13] showed that height, weight, thigh length and circumference all demonstrated a moderately positive correlation with graft size within this review. Such anthropomorphic measurements can be considered surrogate markers for muscular development, both in relation to cross-sectional area and axial muscular length and thus can be considered more relevant markers to base potential graft size upon.…”

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

“…However, the findings from this review also suggest that anthropometric characteristics may not be as strong as MRI in predicting graft diameter. It has been proposed that anthropometric characteristics, specifically weight and height, could serve as surrogate markers of muscle development [52], thus leading to greater graft diameters. Cutoffs for height and weight with an associated sensitivity and specificity for predicting graft diameter above 8 mm were not widely reported from study to study.…”

“…Several studies thereafter have found correlations between magnetic resonance imaging (MRI) evaluation of tendon cross-sectional area (CSA) and graft diameter, advocating for its utility in providing surgeons with a tool for predicting graft size [9,49,62]. Other studies have found significant correlations between anthropometric characteristics, such as height, weight and body mass index (BMI), with graft diameter [6,41,52]. Hence, some have advocated for using both radiographic and demographic parameters for preoperative planning [24,41].…”