Sydney Knee Specialists, Edgecliff, Australia.
Arthroscopy. 2011 Aug;27(8):1055-9. doi: 10.1016/j.arthro.2011.02.035. Epub 2011 Jun 24.
To determine whether the preoperative magnetic resonance imaging (MRI) cross-sectional area (CSA) of the hamstring tendons can predict intraoperative bundle diameters during double-bundle anterior cruciate ligament reconstruction.
A prospective study of 34 patients undergoing anterior cruciate ligament reconstruction with hamstring autografts was performed. CSAs of independent and combined hamstring tendon diameters were correlated to preoperative magnetic resonance images.
Intraoperative tendon diameter measurement positively correlated with preoperative MRI tendon CSA measurement for gracilis (P = .0006), semitendinosus (P = .001), and final graft size (P = .001). Double-stranded gracilis grafts greater than or equal to 5 mm in diameter had a mean preoperative MRI gracilis CSA of 9.98 mm(2) compared with a mean of 7.76 mm(2) for grafts less than 5 mm (P = .002). Double-stranded semitendinosus grafts greater than or equal to 6 mm had a mean preoperative MRI tendon CSA of 17.33 mm(2) compared with 14.80 mm(2) for grafts less than 6 mm (P = .02). Final grafts of diameter greater than or equal to 7 mm had a mean preoperative MRI total tendon CSA of 26.54 mm(2) compared with 22.22 mm(2) for grafts under 7 mm (P = .06).
Preoperative MRI is a clinically useful tool to assess hamstring tendon graft diameter. We recommend preoperative CSA threshold values of 10 mm(2) and 17 mm(2) for the gracilis and semitendinosus tendons, respectively, to reliably predict the potential for a double-bundle anterior cruciate ligament reconstruction.
Level IV, therapeutic case series.
确定术前磁共振成像（MRI）横截面积（CSA）是否可预测双束前交叉韧带重建术中束直径。
对 34 例行腘绳肌腱自体移植前交叉韧带重建的患者进行前瞻性研究。独立和联合腘绳肌腱直径 CSA 与术前 MRI 相关。
术中肌腱直径测量与股薄肌（P =.0006）、半腱肌（P =.001）和最终移植物大小（P =.001）的术前 MRI 肌腱 CSA 测量呈正相关。直径大于或等于 5mm 的双股股薄肌移植物的平均术前 MRI 股薄肌 CSA 为 9.98mm²，而直径小于 5mm 的移植物的平均 CSA 为 7.76mm²（P =.002）。直径大于或等于 6mm 的双股半腱肌移植物的平均术前 MRI 肌腱 CSA 为 17.33mm²，而直径小于 6mm 的移植物的平均 CSA 为 14.80mm²（P =.02）。直径大于或等于 7mm 的最终移植物的平均术前 MRI 总肌腱 CSA 为 26.54mm²，而直径小于 7mm 的移植物的平均 CSA 为 22.22mm²（P =.06）。
术前 MRI 是评估腘绳肌腱移植物直径的一种有用的临床工具。我们建议股薄肌和半腱肌的术前 CSA 阈值分别为 10mm²和 17mm²，以可靠地预测双束前交叉韧带重建的可能性。
IV 级，治疗性病例系列。
