Gupta Ravi, Malhotra Anubhav, Masih Gladson David, Khanna Tanu
Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India.
J Orthop Surg (Hong Kong). 2017 Jan;25(1):2309499017690997. doi: 10.1177/2309499017690997.
Preoperative prediction of hamstring tendon lengths and graft diameter for anterior cruciate ligament (ACL) reconstruction enables better preoperative planning. Presently, no study exists for Indian population where both derivation and verification of a mathematical equation for accurate prediction of hamstring graft dimensions have been done. This study was conducted in two phases: First phase ( derivation cohort): devoted to the study of correlation of length of hamstring tendons and graft diameter with various anthropometric measurements in 123 patients undergoing ACL reconstruction. Length of semitendinosus (ST) was observed to have a strong correlation with leg length ( r = 0.719), whereas that of gracilis (G) had a strong correlation with patient height ( r = 0.768). Quadrupled diameter (QD) had a strong correlation with patient height and thigh length ( r = 0.685 and 0.680, respectively). Using Pearson correlation coefficient, multiple stepwise linear regressions, and analysis of variance test, predictive equations were developed to predict the length of ST and G and QD. Second phase ( verification cohort): This was a blinded prospective study done on 300 patients to further authenticate and test the accuracy of equations developed. Here, a steady correlation was found between the observed and predicted values of length of ST, G and QD, with correlation coefficients being 0.838, 0.847, and 0.767, respectively. Thus, we can safely conclude that clinically measurable anthropometric variables can reliably predict hamstring graft dimensions. This is likely to prove useful in better preoperative planning of ligament reconstructions.
前交叉韧带(ACL)重建术中腘绳肌腱长度和移植物直径的术前预测有助于更好地进行术前规划。目前,尚未有针对印度人群的研究,在该研究中对准确预测腘绳肌移植物尺寸的数学方程进行了推导和验证。本研究分两个阶段进行:第一阶段(推导队列):致力于研究123例接受ACL重建患者的腘绳肌腱长度和移植物直径与各种人体测量学指标之间的相关性。观察到半腱肌(ST)长度与腿长有很强的相关性(r = 0.719),而股薄肌(G)长度与患者身高有很强的相关性(r = 0.768)。四倍直径(QD)与患者身高和大腿长度有很强的相关性(分别为r = 0.685和0.680)。使用Pearson相关系数、多元逐步线性回归和方差分析测试,建立了预测方程以预测ST、G和QD的长度。第二阶段(验证队列):这是一项对300例患者进行的盲法前瞻性研究,以进一步验证和测试所建立方程的准确性。在此,发现ST、G和QD长度的观察值与预测值之间存在稳定的相关性,相关系数分别为0.838、0.847和0.767。因此,我们可以有把握地得出结论,临床可测量的人体测量学变量可以可靠地预测腘绳肌移植物尺寸。这可能对韧带重建更好的术前规划很有用。