Henkelman Erik, Ayres Jack M, Prô Stephan L
University of Kansas Medical Center, Kansas City, Kansas, U.S.A.
Prisma Health/University of South Carolina School of Medicine, Columbia, South Carolina, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Apr 8;6(2):100844. doi: 10.1016/j.asmr.2023.100844. eCollection 2024 Apr.
To determine the effectiveness of preoperative magnetic resonance imaging (MRI) measurements of the cross-sectional area (CSA) of the semitendinosus tendon in predicting the intraoperative quadrupled semitendinosus graft diameter of a posteriorly harvested hamstring autograft for anterior cruciate ligament (ACL) reconstruction.
A retrospective review of patients who underwent ACL reconstruction with autograft using a posterior hamstring harvest was performed. Patient demographics and operative reports were reviewed, and measurements of the CSA of the semitendinosus on MRI were performed. Multiple linear regression was used to analyze the predictors for graft diameter. A value < .05 was considered statistically significant. Interrater and intrarater reliability were calculated.
280 patients were included. Patient height ( < .0001), and CSA of the semitendinosus ( < .0001) were significant predictors. Patients shorter than 63 inches had an average graft diameter of 7.89 mm compared to 8.69 mm for patients above 63 in ( < .001). The formula for the model is as follows: Graft diameter (mm) = 2.74 + .067·Height (in) + .00009 · Weight (lbs) + .0018 · Age (years) +.12·Gender (1 if M, 0 if F) 8.56 · CSA (cm). The for the model (0.5620), was greater than models using only height ( = .4092) or only CSA Semitendinosus ( = .3932). None of the interaction terms between covariates (e.g., height, weight, age, gender) were significant. Age ( =.6400), weight ( = .9970), and gender ( = .6700) were not significant predictors. Both intraclass (ICC = 0.864, 95% CI=[0.791, 0.912]) and interclass correlation (ICC=0.827, 95% CI=[0.715, 0.894]) showed good reliability.
CSA semitendinosus tendon and patient height independently perform similarly as predictors of graft diameter. When used together, CSA and height accurately predict the graft diameter. In particular, for patients under 63 in tall who demonstrated an average graft diameter below the minimum 8 mm, as suggested by the literature, this may be a useful tool for preoperative planning of patients intending to undergo ACL reconstruction with posterior hamstring harvest.
Level III, diagnostic: retrospective cohort study.
确定术前磁共振成像（MRI）测量半腱肌肌腱横截面积（CSA）对预测术中取自后方的自体腘绳肌腱移植用于前交叉韧带（ACL）重建时四倍半腱肌移植物直径的有效性。
对采用后方腘绳肌取材的自体移植物进行ACL重建的患者进行回顾性研究。回顾患者人口统计学资料和手术报告，并在MRI上测量半腱肌的CSA。采用多元线性回归分析移植物直径的预测因素。P值<0.05被认为具有统计学意义。计算评分者间和评分者内信度。
纳入280例患者。患者身高（P<0.0001）和半腱肌的CSA（P<0.0001）是显著的预测因素。身高低于63英寸的患者平均移植物直径为7.89mm，而身高高于63英寸的患者为8.69mm（P<0.001）。该模型的公式如下：移植物直径（mm）=2.74 + 0.067×身高（英寸）+ 0.00009×体重（磅）+ 0.0018×年龄（岁）+ 0.12×性别（男性为1，女性为0）- 8.56×CSA（平方厘米）。该模型的R²（0.5620）大于仅使用身高（R² = 0.4092）或仅使用半腱肌CSA（R² = 0.3932）的模型。协变量（如身高、体重、年龄、性别）之间的交互项均无显著意义。年龄（P = 0.6400）、体重（P = 0.9970）和性别（P = 0.6700）不是显著的预测因素。组内相关系数（ICC = 0.864，95%CI = [0.791, 0.912]）和组间相关系数（ICC = 0.827，95%CI = [0.715, 0.894]）均显示出良好的信度。
半腱肌肌腱CSA和患者身高作为移植物直径的预测因素，单独使用时表现相似。两者联合使用时，能准确预测移植物直径。特别是对于身高低于63英寸的患者，其平均移植物直径低于文献建议的最小8mm，这对于打算采用后方腘绳肌取材进行ACL重建的患者术前规划可能是一个有用的工具。
III级，诊断性：回顾性队列研究。
