Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, Kaufmann Building, Suite 1011, Pittsburgh, PA, 15213, USA.
Department of Physical Medicine and Rehabilitation, University of Pittsburgh, 3471 Fifth Avenue, LSK Building, Suite 201, Pittsburgh, PA, 15213, USA.
Knee Surg Sports Traumatol Arthrosc. 2019 Mar;27(3):797-804. doi: 10.1007/s00167-018-5101-5. Epub 2018 Aug 25.
Previous studies reported sonography was inferior to MRI to predict hamstring tendon graft diameter for ACL reconstruction. This study aimed to investigate the correlation between intraoperative hamstring tendon graft diameter and its preoperative measurement using different sonographic scanning protocol from previous studies.
Two cadaveric knees were utilized for validation. Sonographically guided gracilis tendon (G) and semitendinosus tendon (ST) injections were performed at myotendinous junction of sartorius using colored latex and then dissection was performed. In the clinical studies, 28 patients underwent primary ACL reconstruction were enrolled. Cross-sectional area (CSA) of G and ST were measured at myotendinous junction of Sartorius. The diameter of doubled G (2G), doubled ST (2ST) and quadrupled ST + G (4STG) were intraoperatively measured using graft sizing devices with 0.5-mm increments.
Cadaveric dissection showed the presence of latex on the surface of G and ST at myotendinous junction of Sartorius in all specimens. In the clinical studies, CSA of G, ST, and ST + G significantly correlated with diameter of 2G (r = 0.464, p = 0.039), 2ST (r = 0.712, p < 0.001), and 4STG (r = 0.792, p < 0.001), respectively. As a result of the simple linear regression analysis, 4STG diameter could be predicted by the following formula: 4.345 + 0.210 × CSA. The differences between calculated diameter by this formula and intraoperative 4STG diameter were within ± 0.5 mm in 89.3% (25/28) of subjects.
The diameter of 2ST and 4STG can be reliably predicted based on sonographic CSA measurement preoperatively. Sonography is a cost-effective alternate to repeat MRI to predict hamstring graft diameter preoperatively.
Diagnostic study; Level II.
先前的研究报告称，在预测 ACL 重建中腘绳肌腱移植物的直径方面，超声检查不如 MRI。本研究旨在从先前的研究中使用不同的超声扫描方案，调查术中腘绳肌腱移植物直径与其术前测量之间的相关性。
利用 2 具尸体膝关节进行验证。使用彩色乳胶在缝匠肌的肌-肌腱交界处进行股薄肌（G）和半腱肌（ST）的超声引导注射，然后进行解剖。在临床研究中，纳入 28 例接受初次 ACL 重建的患者。在缝匠肌的肌-肌腱交界处测量 G 和 ST 的横截面积（CSA）。使用带有 0.5 毫米增量的移植物尺寸测量设备，术中测量 G 两倍（2G）、ST 两倍（2ST）和 4 倍 ST+G（4STG）的直径。
尸体解剖显示，在所有标本的缝匠肌肌-肌腱交界处的 G 和 ST 表面均存在乳胶。在临床研究中，G、ST 和 ST+G 的 CSA 与 2G（r=0.464，p=0.039）、2ST（r=0.712，p<0.001）和 4STG（r=0.792，p<0.001）的直径显著相关。通过简单线性回归分析，4STG 直径可以通过以下公式预测：4.345+0.210×CSA。在 89.3%（25/28）的受试者中，该公式计算的直径与术中 4STG 直径的差异在±0.5 毫米内。
根据术前超声 CSA 测量，2ST 和 4STG 的直径可以可靠预测。超声是一种经济有效的替代重复 MRI 来预测腘绳肌腱移植物直径的方法。
诊断研究；II 级。
