Vivekanantha Prushoth, Grzela Patrick, Wong Stephanie, Mansour Fadi, Khalik Hassaan Abdel, Johnson Jansen, Hantouly Ashraf, de Sa Darren
Michael DeGroote School of Medicine, McMaster University Medical Center, McMaster University, Hamilton, Ontario, Canada.
Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada.
Knee Surg Sports Traumatol Arthrosc. 2024 Jun;32(6):1470-1491. doi: 10.1002/ksa.12179. Epub 2024 Apr 21.
To evaluate the utility of semitendinosus tendon (ST) and gracilis tendon (GT) cross-sectional area (CSA) on magnetic resonance imaging (MRI) and anthropometric characteristics in preoperative estimation of graft diameter in patients undergoing anterior cruciate ligament reconstruction (ACLR) with four-strand hamstring autografts.
Three databases were searched on 29 August 2023. The authors adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and R-AMSTAR (Revised Assessment of Multiple Systematic Review) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Data on demographics, anthropometric characteristics, imaging techniques, tendon CSA, correlation coefficients, sensitivities, specificities, regression models and cutoffs for predicting intraoperative graft diameters above 8 mm were recorded.
Forty-six studies comprising 4140 patients were included. Twelve of 19 (63.2%) studies reporting on ST + GT CSA found a moderate to very high correlation with intraoperative graft diameter. Five of 10 (50%) and one of seven (14.3%) studies reporting on ST CSA and GT CSA, respectively, found a moderate to high correlation with intraoperative graft diameter. Cutoffs of ST + GT CSA for predicting graft diameters above 8 mm ranged from 15.8 to 31.2 mm. Nine of 35 (25.7%) studies that reported on height found a moderate to very high correlation with graft diameter. Seven of 33 (21.2%) studies reporting on weight found a moderate correlation with graft diameter.
Of the MRI parameters assessed, ST + GT CSA was the most reliable predictor of graft diameter. However, cutoffs, sensitivities, and specificities for predicting diameters above 8 mm were highly variable. Anthropometric characteristics in general were less predictive of graft diameter than MRI parameters. This information can be used by clinicians to predict patients at risk for ACLR failure due to insufficient graft size.
Level IV.
评估在接受四股绳肌自体移植物前交叉韧带重建（ACLR）的患者中，磁共振成像（MRI）上半腱肌肌腱（ST）和股薄肌肌腱（GT）的横截面积（CSA）以及人体测量特征在术前估计移植物直径方面的效用。
于2023年8月29日检索了三个数据库。作者遵循PRISMA（系统评价和Meta分析的首选报告项目）和R-AMSTAR（修订的多个系统评价评估）指南以及《Cochrane干预措施系统评价手册》。记录了关于人口统计学、人体测量特征、成像技术、肌腱CSA、相关系数、敏感性、特异性、回归模型以及预测术中移植物直径大于8毫米的截断值的数据。
纳入了46项研究，共4140例患者。在报告ST + GT CSA的19项研究中，有12项（63.2%）发现与术中移植物直径存在中度至高度相关性。分别报告ST CSA和GT CSA的10项研究中的5项（50%）和7项研究中的1项（14.3%）发现与术中移植物直径存在中度至高度相关性。预测移植物直径大于8毫米的ST + GT CSA截断值范围为15.8至31.2毫米。在报告身高的35项研究中，有9项（25.7%）发现与移植物直径存在中度至高度相关性。在报告体重的33项研究中，有7项（21.2%）发现与移植物直径存在中度相关性。
在所评估的MRI参数中，ST + GT CSA是移植物直径最可靠的预测指标。然而，预测直径大于8毫米的截断值、敏感性和特异性差异很大。一般而言，人体测量特征对移植物直径的预测性低于MRI参数。临床医生可利用这些信息预测因移植物尺寸不足而有ACLR失败风险的患者。
四级。
