2015 ISAKOS Biennial Congress ePoster #1364

How can we Predict the Size of Frequently Used Autografts in ACL Reconstruction?

Philip Zakko, Pittsburgh, PA UNITED STATES
Carola F. van Eck, MD, PhD, Pittsburgh, PA UNITED STATES
James J. Irrgang, PT, PhD, FAPTA, Pittsburgh, PA UNITED STATES
Freddie H. Fu, MD, Pittsburgh, PA UNITED STATES

University of Pittsburgh, Pittsburgh, PA, USA

FDA Status Not Applicable

Summary: This study presents methods to preoperatively determine the sizes of the tendons for all possible autograft choices used in ACL reconstruction using MRI

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Abstract:

Background

Various graft types can be used in anterior cruciate ligament (ACL) reconstruction. However, it can be difficult to predict the size of available autografts prior to graft harvesting. This study aimed to present a Magnetic Resonance Imaging (MRI) method to measure the size of available autograft types preoperatively. The secondary aim was to determine if there is a relationship between graft size as measured on MRI and patient anthropometric data such as height and weight.

Methods

62 subjects who underwent ACL surgery were included in this study. Patient anthropometric data were recorded. Two raters measured the size of the quadriceps and patellar tendon and patella on MRI. Intra- and inter-rater reliability were calculated. The Pearson correlation coefficient was used to determine if a relationship between MRI measurements and anthropometric data existed.

Results

The mean thickness of the quadriceps tendon, patellar tendon and patella were 8.4 ± 1.5 mm, 4.3 ± 0.8 mm and 21.1 ± 1.9 mm, respectively. The inter- and intra-rater reliability was > 0.9 for all measurements. The Pearson Correlation Coefficients between anthropometric data and the quadriceps tendon thickness were statistically significant for height (r = 0.281, P < 0.027), weight (r = 0.315, P < 0.013) and BMI (r = 0.263, P < 0.039). For the patellar tendon thickness they were significant for height (r = 0.363, P < 0.004) and weight (r = 0.326, P < 0.010). And for the patella thickness for height (r = 0.404, P < 0.001), weight (r = 0.486, P < 0.0005), and BMI (r = 0.428, P < 0.001).

Conclusion

The results of this study demonstrated there is only a weakly positive correlation between anthropometric patient data and the size of several autograft types. However, measuring graft size on the routine MRI preoperatively was found to be very reliable.

CLINICAL RELEVANCE
Currently, there are methods to preoperatively predict hamstring tendon autograft size using anthropometric data as well as MRI measurements, but there is no method to predict the size of the quadriceps or the patellar tendon autograft. These tendons are commonly used as in ACL reconstructions, thus preoperative knowledge about their sizes will have a significant benefit for surgeons. This study presents methods to preoperatively determine the sizes of the tendons for all possible autograft choices used in ACL reconstruction using MRI.