Predicting Quadrupled Graft Length and Diameter Using Single-Strand Tendon Dimensions in All-Inside Anterior Cruciate Ligament Reconstruction.

PURPOSE

To determine whether single-strand semitendinosus autograft or allograft dimensions can reliably predict quadrupled graft diameter and length.

METHODS

Intraoperative semitendinosus graft measurements were recorded for consecutive all-inside anterior cruciate ligament (ACL) reconstructions from 2013 to 2016 and retrospectively reviewed. Intraoperative single-strand tendon length and width and the corresponding quadrupled graft length and diameter were recorded. Pearson correlation coefficients were used to assess the linear association between single-strand width and quadrupled diameter, as well as between single-strand length and quadrupled length. Linear regression models were used to predict quadrupled values. To test the accuracy of the predicted quadrupled values, dimensions from an additional series of 30 all-inside ACL reconstructions were reviewed.

RESULTS

Seventy-three ACL reconstruction procedures were reviewed. We excluded 12 grafts because gracilis and semitendinosus constructs were used. Thus 61 semitendinosus quadrupled grafts (30 autografts and 31 allografts) were included. Single-strand width was associated with quadrupled diameter (P = .012), and single-strand length was associated with quadrupled graft length (P < .001).

CONCLUSIONS

Quadrupled hamstring graft length and diameter may be accurately predicted based on length and width of the semitendinosus tendon used for all-inside, single-bundle ACL reconstruction. The ability to predict quadrupled graft dimensions can guide the surgeon in intraoperative decision making and ensure the desired ACL graft dimensions are achieved, thereby minimizing the risk of ACL reconstruction failure.

LEVEL OF EVIDENCE

Level III, retrospective comparative study.