Background:The literature is scanty regarding the anthropometric predictors on the diameter of quadruple hamstring graft obtained in anterior cruciate ligament (ACL) reconstruction in Indian population. Minimum diameter of the graft for ACL reconstruction should be >7 mm to preclude failure. The objective of this study was to assess the prediction of the hamstring graft diameter by several anthropometric parameters including age, thigh circumference, weight, height and body mass index (BMI).Materials and Methods:46 consecutive patients who had undergone ACL reconstruction by the same surgeon using quadruple hamstring grafts were evaluated. The age, thigh circumference of the normal side, height, weight and BMI were recorded preoperatively and Pearson correlation was done using these parameters with graft diameter measured intraoperatively. Regression analysis in a stepwise manner was undertaken to assess the influence of individual anthropometric parameters on the graft diameter.Results:There were 44 males and 2 females. Mean age was 29.4 years, mean height was 172.6 cm, mean weight was 70.9 kg, mean BMI was 23.8 kg/m2, mean thigh circumference was 47.1 cm and mean graft diameter was 7.9 mm. There was a positive correlation individually between the thigh circumference and graft diameter obtained (r = 0.8, P < 0.01, n = 46), and between the height and graft diameter (r = 0.8, P < 0.01, n = 46). On the regression analysis thigh circumference and height were found to be significant predictors of graft diameter giving the following equation: Graft diameter (mm) = 0. 079 height (cm) +0.068 thigh circumference (cm) −9.031.Conclusion:Preoperatively using the above equation if graft diameter came out to be <7 mm then alternate options of graft material must be kept in mind in order to prevent failure.
Introduction:We conducted a prospective study to find out change in limb length (lengthening/shortening) after total knee arthroplsty in unilateral and bilateral total knee arthroplasty (TKA) because few literature is available regarding limb length discrepancy in TKA in comparison to total hip arthroplasty. Limb length discrepancy (LLD) may lead to low back pain and gait abnormalities. Material and methods: We divided 58 patients into two groups: Group A (28 patients) includes patients who underwent unilateral TKA and Group B (30 patients) includes patients who underwent bilateral TKA. We assessed the patients clinico-radiologically in terms of limb length (supine position), deformity, Sagital-flexion deformity/extensor lag, coronal -varus/valgus, range of motion, knee stability, patellar tracking and Hip-knee-ankle angle preoperatively and postoperatively. Results: In group A, mean limb length difference (operated limb gained length as compared to unoperated limb) was 1.11 cm. Out of 22 patients (78%) in whom limb length discrepancy was present, only 7 patients (31%) having limb length discrepancy perceived it. In group B, mean limb length difference was 1.03 cm. Fourteen patients (47%) in group B had LLD but none of them perceived it. Clinically 22 patients (78%) in group A and 14 patients (47%) in group B had LLD. Radiologically 25 patients (89%) in group A and 22 patients (73%) in group B had LLD. Out of the 7 patients who perceived LLD, all had LLD radiologically too.
Conclusion:We reckoned that limb length discrepancy is more common in unilateral TKA. Limb length discrepancy of 2 cm or more is perceived by the patients operated for unilateral TKA. But in bilateral TKA, none of the patient perceived LLD because in this group LLD was less than 2 cm. Limb length discrepancy may leads to dissatisfaction of the patients and poor functional outcome.
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