Preoperative estimation of hamstring autograft graft diameter in anterior cruciate ligament reconstruction with a new simple method using magnetic resonance imaging

Background

The aim of this study was to predict intraoperative graft diameter with our new method by evaluating the cross-sectional areas (CSAs) of the hamstrings in axial sections of MRI.

Methods

This study included 78 patients who underwent single-bundle ACLR between 2022 and 2023. MRIs of the patients were evaulated preoperatively and four CSAs of the hamstring tendons were measured in two different regions by two participants. CSA measurements were calculated manually and the total area was measured by adding up these cross-sectional areas separately. This value was considered as the area of a single circle and the radius was calculated using the area formula of the circle (A = πr²)

Results

For participant I, perfect agreement was found in semitendinosus measurement (κ = 0.849), moderate agreement was detected at the medial condyle level (κ = 0.520). For participant II, perfect agreement was found in the medial condyle region (κ = 0.849), substantial agreement was obtained at the joint level (0.631). In the gracilis tendon evaluation of both participants, substantial and moderate agreement was found at the joint level and at the medial condyle level, respectively. CSA of hamstring tendons measured at the joint level by both participants were found to be positively correlated with the intraoperative graft diameter (r = 0.51) (P < 0.05)

Conclusions

Preoperative MRI assesment could be a effective tool for determing preliminary information about the hamstring graft diameters. Moreover, it is observed that quadruple hamstring graft sizes were more correlated with MRI measurements at the joint level than medial condyle level by using circle area formula.