MRI Accurately Predicts Quadrupled Semitendinosus Autograft Size Using Posterior Hamstring Harvest for ACL Reconstruction

Erik Henkelman M.D. , Jack M. Ayres M.D. , Stephan L. Prô M.D.
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Abstract

Purpose

To determine the effectiveness of preoperative magnetic resonance imaging (MRI) measurements of the cross-sectional area (CSA) of the semitendinosus tendon in predicting the intraoperative quadrupled semitendinosus graft diameter of a posteriorly harvested hamstring autograft for anterior cruciate ligament (ACL) reconstruction.

Methods

A retrospective review of patients who underwent ACL reconstruction with autograft using a posterior hamstring harvest was performed. Patient demographics and operative reports were reviewed, and measurements of the CSA of the semitendinosus on MRI were performed. Multiple linear regression was used to analyze the predictors for graft diameter. A P value < .05 was considered statistically significant. Interrater and intrarater reliability were calculated.

Results

280 patients were included. Patient height (P < .0001), and CSA of the semitendinosus (P < .0001) were significant predictors. Patients shorter than 63 inches had an average graft diameter of 7.89 mm compared to 8.69 mm for patients above 63 in (P < .001). The formula for the model is as follows: Graft diameter (mm2) = 2.74 + .067·Height (in) + .00009 · Weight (lbs) + .0018 · Age (years) +.12·Gender (1 if M, 0 if F) + 8.56 · CSA (cm2). The R2 for the model (0.5620), was greater than models using only height (R2 = .4092) or only CSA Semitendinosus (R2 = .3932). None of the interaction terms between covariates (e.g., height, weight, age, gender) were significant. Age (P =.6400), weight (P = .9970), and gender (P = .6700) were not significant predictors. Both intraclass (ICC = 0.864, 95% CI=[0.791, 0.912]) and interclass correlation (ICC=0.827, 95% CI=[0.715, 0.894]) showed good reliability.

Conclusion

CSA semitendinosus tendon and patient height independently perform similarly as predictors of graft diameter. When used together, CSA and height accurately predict the graft diameter. In particular, for patients under 63 in tall who demonstrated an average graft diameter below the minimum 8 mm, as suggested by the literature, this may be a useful tool for preoperative planning of patients intending to undergo ACL reconstruction with posterior hamstring harvest.

Level of Evidence

Level III, diagnostic: retrospective cohort study.

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利用腘绳肌后侧取材法进行前交叉韧带重建时,核磁共振成像可准确预测四倍半腱肌自体移植物的大小
目的确定术前对半腱肌肌腱横截面积(CSA)的磁共振成像(MRI)测量结果在预测术中用于前交叉韧带(ACL)重建的后方取材腘绳肌自体移植物的四倍半腱肌移植物直径方面的有效性。回顾了患者的人口统计学特征和手术报告,并在核磁共振成像上测量了半腱肌的CSA。采用多元线性回归分析移植物直径的预测因素。P 值大于 0.05 即为具有统计学意义。结果 280 例患者被纳入研究。患者身高(P <.0001)和半腱肌CSA(P <.0001)是重要的预测因素。身高低于 63 英寸的患者的平均移植物直径为 7.89 毫米,而身高高于 63 英寸的患者的平均移植物直径为 8.69 毫米(P < .001)。模型公式如下移植物直径(平方毫米)= 2.74 + .067-身高(英寸) + .00009 -体重(磅) + .0018 -年龄(岁) +.12 -性别(男为 1,女为 0) + 8.56 -CSA(平方厘米)。该模型的 R2(0.5620)大于仅使用身高(R2 = 0.4092)或仅使用半腱肌CSA(R2 = 0.3932)的模型。协变量(如身高、体重、年龄、性别)之间的交互项均不显著。年龄(P =.6400)、体重(P =.9970)和性别(P =.6700)都不是重要的预测因素。类内相关(ICC=0.864,95% CI=[0.791,0.912])和类间相关(ICC=0.827,95% CI=[0.715,0.894])均显示出良好的可靠性。当 CSA 和身高一起使用时,可准确预测移植物直径。特别是对于身高在 63 岁以下、平均移植物直径低于最小 8 毫米的患者,正如文献所建议的那样,这可能是一种有用的工具,可用于打算接受前交叉韧带重建术和腿后肌腱摘除术的患者的术前规划。
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CiteScore
2.70
自引率
0.00%
发文量
218
审稿时长
45 weeks
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