Qiao Yi, Zhang Xiuyuan, Zhao Yu, Wu Chenliang, Xu Caiqi, Chen Jie, Zhao Jinzhong, Zhao Song
Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Changhai Hospital, Shanghai, China.
Orthop J Sports Med. 2024 Aug 21;12(8):23259671241248187. doi: 10.1177/23259671241248187. eCollection 2024 Aug.
Adequate graft size and length are crucial factors in anterior cruciate ligament (ACL) reconstruction. Accurate identification of patients who may be at risk for an insufficient length or size of the hamstring tendon (HT) can aid surgeons in preoperative planning.
To evaluate whether magnetic resonance imaging (MRI) or ultrasound could more accurately predict the size of the semitendinosus tendon (ST) and gracilis tendon (GT) and to investigate the correlation between anthropometry, graft size, and imaging measurements to find a predictive formula.
Cross-sectional study; Level of evidence, 3.
Included in the study were 36 patients who underwent ACL reconstruction with HT autograft at our institution between July 2021 and May 2022. Anthropometric data and MRI and ultrasound measurements were collected preoperatively. The length and diameter of the HT were recorded intraoperatively. Correlations between anthropometry, graft size, and imaging measurements were analyzed. Linear regression analysis was performed to construct a prediction formula.
The intraoperative graft diameters of the ST and GT were weakly to moderately associated with their cross-sectional areas as measured by MRI and ultrasound. MRI and ultrasound interpreted 11.9% to 15.7% and 18.4% to 41.7% of the variation in the graft diameter of the HT, with an accuracy of 50.0% to 55.6% and 69.4% to 86.1%, respectively. The intraoperative lengths of the ST and GT were both associated with patient height and tendon lengths as measured by ultrasound. Additionally, intraoperative GT length was associated with patient weight. Four formulas combining relevant anthropometric parameters and imaging measurements were calculated from multilinear regression analysis, explaining up to 46.3% of the variance in the size of HT.
Ultrasound and MRI alone showed limited ability to predict the graft diameter of the ST and GT, while ultrasound could more accurately predict the graft size than MRI. Among the different anthropometric variables, height was the most influential in predicting tendon length.
足够的移植物大小和长度是前交叉韧带（ACL）重建中的关键因素。准确识别可能存在腘绳肌腱（HT）长度或大小不足风险的患者有助于外科医生进行术前规划。
评估磁共振成像（MRI）或超声是否能更准确地预测半腱肌腱（ST）和股薄肌腱（GT）的大小，并研究人体测量学、移植物大小和影像学测量之间的相关性，以找到一个预测公式。
横断面研究；证据等级，3级。
纳入2021年7月至2022年5月期间在本机构接受HT自体移植进行ACL重建的36例患者。术前收集人体测量数据以及MRI和超声测量结果。术中记录HT的长度和直径。分析人体测量学、移植物大小和影像学测量之间的相关性。进行线性回归分析以构建预测公式。
术中ST和GT的移植物直径与通过MRI和超声测量的横截面积呈弱至中度相关。MRI和超声分别解释了HT移植物直径变化的11.9%至15.7%和18.4%至41.7%，准确率分别为50.0%至55.6%和69.4%至86.1%。术中ST和GT的长度均与患者身高以及超声测量的肌腱长度相关。此外，术中GT长度与患者体重相关。通过多线性回归分析计算出四个结合相关人体测量参数和影像学测量的公式，解释了高达46.3%的HT大小差异。
单独使用超声和MRI预测ST和GT移植物直径的能力有限，而超声比MRI能更准确地预测移植物大小。在不同的人体测量变量中，身高对预测肌腱长度的影响最大。
