Ayres Jack M, Ose Benjamin M, Morey Tucker, Brown Elizabeth, Mar Damon, Henkelman Erik, Vopat Bryan G, Goodman Ian, Randall Jeffrey
University of Kansas Medical Center, Kansas City, Kansas, U.S.A.
Department of Orthopedic Surgery, Prisma Health Orthopedics/University of South Carolina School of Medicine, Columbia, South Carolina, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Sep 12;7(1):101001. doi: 10.1016/j.asmr.2024.101001. eCollection 2025 Feb.
To determine if preoperative magnetic resonance imaging (MRI) measurements of semitendinosus and gracilis tendon cross-sectional area (CSA) could be used in predicting the intraoperative diameter of a 5-strand hamstring autograft.
A retrospective review was performed of patients who underwent anterior cruciate ligament (ACL) reconstruction with a 5-strand hamstring autograft. All patients undergoing a 5-strand hamstring autograft ACL reconstruction from a single surgeon between 2018 and 2021 were included in this analysis. CSA of both the semitendinosus (CSAst) and gracilis (CSAgr) tendons were measured on preoperative MRI. Demographic and operative data were recorded via chart review. Analyses of within-rater and between-rater reliability were performed. Multiple linear regression was used to analyze the predictors of graft diameter.
A total of 45 ACLs were included in this study. An initial multiple linear regression model included multiple patient-independent variables ( = 0.62, < .001), but CSAst was the only significant predictor of graft diameter. Accordingly, a second multiple linear regression model was created using CSAst and CSAgr ( = 0.61, < .001). Both CSAst and CSAgr were significant predictors of graft diameter. The resulting equation for determining the graft diameter based on CSAst and CSAgr is as follows: [Graft Diameter (mm)] = 5.324 + 0.124 ∗ [CSAst (mm)] + 0.183 ∗ [CSAgr (mm)].
CSA measurements of the semitendinosus and gracilis tendons on preoperative MRI axial imaging, measured at the level for which the femoral condyle was the widest, may be used to predict the intraoperative graft diameter for ACL reconstruction using the 5-strand autograft technique.
Predicting ACL autograft size on preoperative MRI can aid in preoperative planning, including choice of graft.
确定术前磁共振成像（MRI）测量的半腱肌和股薄肌腱横截面积（CSA）是否可用于预测五股绳肌自体移植物的术中直径。
对接受五股绳肌自体移植物前交叉韧带（ACL）重建的患者进行回顾性研究。本分析纳入了2018年至2021年间由单一外科医生进行五股绳肌自体移植物ACL重建的所有患者。术前MRI测量半腱肌（CSAst）和股薄肌（CSAgr）肌腱的CSA。通过病历审查记录人口统计学和手术数据。进行了评分者内和评分者间可靠性分析。使用多元线性回归分析移植物直径的预测因素。
本研究共纳入45例ACL。最初的多元线性回归模型包括多个与患者无关的变量（R² = 0.62，P <.001），但CSAst是移植物直径的唯一显著预测因素。因此，使用CSAst和CSAgr创建了第二个多元线性回归模型（R² = 0.61，P <.001）。CSAst和CSAgr都是移植物直径的显著预测因素。根据CSAst和CSAgr确定移植物直径的最终方程如下：[移植物直径（mm）]= 5.324 + 0.124 × [CSAst（mm）]+ 0.183 × [CSAgr（mm）]。
术前MRI轴位成像在股骨髁最宽水平测量的半腱肌和股薄肌腱的CSA测量值，可用于预测使用五股自体移植物技术进行ACL重建的术中移植物直径。
术前MRI预测ACL自体移植物大小有助于术前规划，包括移植物的选择。
