Sumanont Sermsak, Mahaweerawat Chatchada, Boonrod Arunnit, Thammaroj Punthip, Boonrod Artit
Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Orthop J Sports Med. 2019 Jan 23;7(1):2325967118822318. doi: 10.1177/2325967118822318. eCollection 2019 Jan.
Adequate graft size and length are crucial factors that correlate with improved outcomes after anterior cruciate ligament reconstruction with a semitendinosus (ST) tendon autograft alone. Anthropometric parameters could be used as predictors of graft measurements but they have shown imprecise correlation in some patients.
To evaluate the accuracy of ultrasound (US) for the preoperative evaluation of ST graft size and length.
Cohort study (diagnosis); Level of evidence, 3.
A total of 40 patients were included in this study. Patient sex, age, anthropometric parameters, and preoperative US measurements were recorded. After the ST tendons were harvested, their lengths as well as the diameters of the 4-strand ST grafts were recorded. Correlations between patient US measurements were analyzed. Inadequate ST graft length was defined at <28 cm, and inadequate 4-strand ST graft diameter was defined at <8 mm.
The prevalence of patients with an ST graft length <28 cm was 47.5%, and the prevalence of patients with a 4-strand ST graft diameter <8 mm was 42.5%. US measurements had a strong, significant correlation with the ST graft length ( < .001) and a moderate correlation with the 4-strand ST graft diameter ( < .001). Absolute agreement between the preoperative US measurement of ST graft length and the intraoperative ST graft length showed good reliability (ICC = 0.825). The cross-sectional area (CSA) of the ST tendon at the knee joint level by US showed a weak correlation ( = 0.207) with the 4-strand ST graft diameter ( = .200). A CSA of 16 mm measured by US could be used to predict a 4-strand ST graft diameter ≥8 mm, with a sensitivity of 73.9% and specificity of 76.5%.
Preoperative US measurements of ST tendons had a strong correlation with intraoperative ST graft length and provided good sensitivity to detect a 4-strand ST graft diameter ≥8 mm. All other anthropometric parameters showed a weak to moderate correlation with ST graft length and size.
足够的移植物大小和长度是单独使用半腱肌（ST）肌腱自体移植进行前交叉韧带重建后与改善预后相关的关键因素。人体测量参数可作为移植物尺寸的预测指标，但在一些患者中它们显示出不精确的相关性。
评估超声（US）用于术前评估ST移植物大小和长度的准确性。
队列研究（诊断）；证据等级，3级。
本研究共纳入40例患者。记录患者的性别、年龄、人体测量参数和术前超声测量值。在获取ST肌腱后，记录其长度以及4股ST移植物的直径。分析患者超声测量值之间的相关性。ST移植物长度不足定义为<28 cm，4股ST移植物直径不足定义为<8 mm。
ST移植物长度<28 cm的患者患病率为47.5%，4股ST移植物直径<8 mm的患者患病率为42.5%。超声测量值与ST移植物长度有强且显著的相关性（<0.001），与4股ST移植物直径有中度相关性（<0.001）。术前超声测量的ST移植物长度与术中ST移植物长度之间的绝对一致性显示出良好的可靠性（ICC = 0.825）。超声测量的膝关节水平ST肌腱横截面积（CSA）与4股ST移植物直径（=0.200）呈弱相关性（=0.207）。超声测量的CSA为16 mm可用于预测4股ST移植物直径≥8 mm，敏感性为73.9%，特异性为76.5%。
术前超声测量ST肌腱与术中ST移植物长度有强相关性，并对检测4股ST移植物直径≥8 mm具有良好的敏感性。所有其他人体测量参数与ST移植物长度和大小呈弱至中度相关性。
