Predicting the Hamstring Tendon Diameter Using Anthropometric Parameters

Document Type : RESEARCH PAPER

Authors

1 Guilan Road Trauma Research Center, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran

2 Kerman University of medical sciencesOrthopedic Department, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran

3 Orthopedic Research Center, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran

4 Orthopedics Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

 
Background:
Despite the importance of hamstring tendon autograft, one major disadvantage in applying this technique in the surgical reconstruction of anterior cruciate ligament is individual variability in the tendon diameter. Hence, the purpose of the present study was to use anthropometric parameters such as gender, height and body mass index to predict 4-strand (quadruple) hamstring tendons (gracilis and 2-strand semitendinosus tendons).
 
Methods:
This is a cross-sectional study conducted on all consecutive patients who underwent arthroscopic ACL reconstruction between 2013 and 2015. The anthropometric variables (age, gender, height, and body mass index) were recorded. The quadruple hamstring tendon (gracilis and semitendinosus) autografts were measured using sizing cylinders. The relationship between these parameters was statistically determined using the Pearson Spearman test and linear regression test.
Results:
The mean age of the 178 patients eligible for the study was 29.58±9.93 (118 males and 60 females). The mean hamstring tendon diameter was 7.8±0.7 mm, the mean for males was 7.9±0.6 and for females 7.89± mm (P=0.0001). There were significant correlations between the mean hamstring tendon diameter with BMI (Pearson correlation=0.375, R2=0.380, and P=0.0001), height (Pearson correlation=0.441, R2=0.121, and P=0.0001), and weight (Pearson correlation=0.528, R2= -0.104 and P=0.0001). However,patient’s age and genderwerenot found to be a predictor of the size of the hamstring tendon diameter.
Conclusion:
Based on findings from this study weight, height, body mass index,and the length of the tendon may be predictors of the hamstring tendon diameter for anterior cruciate ligamentreconstruction. These findings could be used in preoperative planning of patients undergoing ACL reconstruction surgery to estimate the size of the graft and select of the appropriate type of graft.

Keywords

Main Subjects


1. Beyzadeoglu T, Akgun U, Tasdelen N, Karahan M.
Prediction of semitendinosus and gracilis autograft
sizes for ACL reconstruction. Knee Surg Sports
Traumatol Arthrosc. 2012; 20(7):1293-7.
2. Stergios PG, Georgios KA, Konstantinos N, Efthymia P,
Nikolaos K, Alexandros PG. Adequacy of semitendinosus
tendon alone for anterior cruciate ligament
reconstruction graft and prediction of hamstring graft
size by evaluating simple anthropometric parameters.
Anat Res Int. 2012; 2012(2012):1-8.
3. Alentorn-Geli E, Samitier G, Alvarez P, Steinbacher
G, Cugat R. Anteromedial portal versus transtibial
drilling techniques in ACL reconstruction: a blinded
cross-sectional study at two- to five-year follow-up.
Int Orthop. 2010; 34(5):747-54.
4. Farshad M, Gerber C, Meyer DC, Schwab A, Blank PR,
Szucs T. Reconstruction versus conservative treatment
after rupture of the anterior cruciate ligament: cost
effectiveness analysis. BMC Health Serv Res. 2011;
11(1):317-26.
5. Ma CB, Keifa E, Dunn W, Fu FH, Harner CD. Can preoperative
measures predict quadruple hamstring
graft diameter? Knee. 2010; 17(1):81-3.
6. Xie G, Huangfu X, Zhao J. Prediction of the graft size
of 4-stranded semitendinosus tendon and 4-stranded
gracilis tendon for anterior cruciate ligament
reconstruction: a Chinese Han patient study. Am J
Sports Med. 2012; 40(5):1161-6.
7. Schwartzberg R, Burkhart B, Lariviere C. Prediction
of hamstring tendon autograft diameter and length
for anterior cruciate ligament reconstruction. Am J
Orthop (Belle Mead NJ). 2008; 37(3):157-9.
8. Wernecke G, Harris IA, Houang MT, Seeto BG, Chen
DB, MacDessi SJ. Using magnetic resonance imaging
to predict adequate graft diameters for autologous
hamstring double-bundle anterior cruciate ligament
reconstruction. Arthroscopy. 2011; 27(8):1055-9.
9. Thomas S, Bhattacharya R, Saltikov JB, Kramer
DJ. Influence of anthropometric features on graft
diameter in ACL reconstruction. Arch Orthop Trauma
Surg. 2013; 133(2):215-8.
10. Treme G, Diduch DR, Billante MJ, Miller MD, Hart JM.
Hamstring graft size prediction: a prospective clinical
evaluation. Am J Sports Med. 2008; 36(11):2204-9.
11. Tuman JM, Diduch DR, Rubino LJ, Baumfeld JA, Nguyen
HS, Hart JM. Predictors for hamstring graft diameter
in anterior cruciate ligament reconstruction. Am J
Sports Med. 2007; 35(11):1945-9.
12. Brittberg M, Aglietti P, Gambardella R. ICRS cartilage
injury evaluation package. Switzerland: International
Cartilage Repair Society (ICRS); 2000.
13. Mardani-Kivi M, Madadi F, Keyhani S, Karimi-Mobarake
M, Hashemi-Motlagh K, Saheb-Ekhtiari K. Anteromedial
portal vs. Transtibial techniques for drilling
femoral tunnel in ACL reconstruction using 4-strand
hamstring tendon: a cross-sectional study with 1-year
follow-up. Med Sci Monit. 2012;18(11):CR674-9.
14. Karimi-Mobarakeh M, Mardani-Kivi M, Mortazavi A,
Saheb-Ekhtiari K, Hashemi-Motlagh K. Role of gracilis
harvesting in four-strand hamstring tendon anterior
cruciate ligament reconstruction: a double-blinded
prospective randomized clinical trial. Knee Surg
Sports Traumatol Arthrosc. 2015; 23(4):1086-91.
15. Wotherspoon SD, Giffin JR, Fowler PJ, Litchfield RB,
Neligan M, Willits KR. Prediction of anterior cruciate
ligament hamstring autograft size using preoperative
magnetic resonance imaging. Orthp Proc. 2009;
91(Suppl II):241.
16. Conte EJ, Hyatt AE, Gatt CJJr, Dhawan A.Hamstring
autograft size can be predicted and is a potential risk
factor for anterior cruciate ligament reconstruction
failure. Arthroscopy. 2014;30(7):882-90.
17. Bickel BA, Fowler TT, Mowbray JG, Adler B, Klingele
K, Phillips G. Preoperative magnetic resonance
imaging cross-sectional area for the measurement of
hamstring autograft diameter for reconstruction of the
adolescent anterior cruciate ligament. Arthroscopy.
2008; 24(12):1336-41.