Using pre-operative MRI to predict intraoperative hamstring graft size for anterior cruciate ligament reconstruction

Leiter, Jeff; Elkurbo, Mohamed; McRae, Sheila; Chiu, James J.; Froese, Warren; MacDonald, Peter B.

doi:10.1007/s00167-016-4205-z

Cited by 42 publications

(69 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies that have investigated both patient characteristics and imaging-based prediction are scarce. 15,16 Our findings were partially in line with Leiter et al, 16 who found CSA measurement of the HTs combined with weight to be most predictive for HT autograft diameter with an explained variance of 29%. On the contrary, Grawe et al 15 found CSA measurement and age as only significant predictors after multivariate analysis.…”

Section: Discussionsupporting

confidence: 88%

“…On the contrary, Grawe et al 15 found CSA measurement and age as only significant predictors after multivariate analysis. A possible explanation of this difference in findings is that Grawe et al 15 included patients from 9 to 58 years, where the study of Leiter et al 16 and the current study comprised an adult population. Adolescents generally have smaller anthropometric measurements.…”

Section: Discussionmentioning

confidence: 71%

“…Accurate prediction of the intraoperative four-stranded HT autograft diameter is of clinical importance, as it may affect graft choice and decrease rerupture rates. Several studies investigated prediction of HT autograft size using patient characteristics 9,13,14 or imaging techniques, 9,15,16 but revealed various results; height, [17][18][19] weight, 16,[18][19][20] body mass index (BMI), 20 leg length, 18 thigh circumference, 18,20 age, 15,20 and gender 13,17,18 are associated with the graft diameter. Studies using imaging techniques to predict HT autograft diameter mostly measured the cross-sectional area (CSA) of semitendinosus and gracilis tendon on preoperative magnetic resonance imaging (MRI) of the knee.…”

mentioning

confidence: 99%

“…Studies using imaging techniques to predict HT autograft diameter mostly measured the cross-sectional area (CSA) of semitendinosus and gracilis tendon on preoperative magnetic resonance imaging (MRI) of the knee. 15,16,[21][22][23] CSA measurement on MRI might be more accurate than patient characteristics to predict HT autograft diameter. 9,23 However, a recent systematic review 23 found considerable variability (r ¼ 0.42-0.93) in the correlation between CSA measurement on preoperative MRI and HT autograft diameter, highlighting the potential limitations of solely CSA measurement to predict the HT autograft diameter.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Predictive Factors for Hamstring Autograft Diameter in Anterior Cruciate Ligament Reconstruction

et al. 2019

View full text Add to dashboard Cite

Multiple studies found hamstring tendon (HT) autograft diameter to be a risk factor for anterior cruciate ligament (ACL) reconstruction failure. This study aimed to determine which preoperative measurements are associated with HT autograft diameter in ACL reconstruction by directly comparing patient characteristics and cross-sectional area (CSA) measurement of the semitendinosus and gracilis tendon on magnetic resonance imaging (MRI). Fifty-three patients with a primary ACL reconstruction with a four-stranded HT autograft were included in this study. Preoperatively we recorded length, weight, thigh circumference, gender, age, preinjury Tegner activity score, and CSA of the semitendinosus and gracilis tendon on MRI. Total CSA on MRI, weight, height, gender, and thigh circumference were all significantly correlated with HT autograft diameter (p < 0.05). A multiple linear regression model with CSA measurement of the HTs on MRI, weight, and height showed the most explained variance of HT autograft diameter (adjusted R 2 = 44%). A regression equation was derived for an estimation of the expected intraoperative HT autograft diameter: 1.2508 + 0.0400 × total CSA (mm2) + 0.0100 × weight (kg) + 0.0296 × length (cm). The Bland and Altman analysis indicated a 95% limit of agreement of ± 1.14 mm and an error correlation of r = 0.47. Smaller CSA of the semitendinosus and gracilis tendon on MRI, shorter stature, lower weight, smaller thigh circumference, and female gender are associated with a smaller four-stranded HT autograft diameter in ACL reconstruction. Multiple linear regression analysis indicated that the combination of MRI CSA measurement, weight, and height is the strongest predictor.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 71%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Predictive Factors for Hamstring Autograft Diameter in Anterior Cruciate Ligament Reconstruction

et al. 2019

View full text Add to dashboard Cite

show abstract

“…1). [30][31][32][33][34][35][36][37][38][39][40][41][42][43] The κ value assessing interreviewer agreement was substantial for title, abstract, and full-text screens, with values of 0.845 (95% CI ¼ 0.82-0.86), 0.930 (95% CI ¼ 0.92-0.94), and 0.975 (95% CI ¼ 0.96-0.98), respectively.…”

Section: Eligibility Assessment and Study Selectionmentioning

confidence: 99%

Can Preoperative Magnetic Resonance Imaging Predict Intraoperative Autograft Size for Anterior Cruciate Ligament Reconstruction? A Systematic Review

Agarwal

Peterson

et al. 2018

J Knee Surg

View full text Add to dashboard Cite

This systematic review explored the utility of preoperative magnetic resonance imaging (MRI) as a tool for predicting intraoperative graft size for anterior cruciate ligament (ACL) reconstruction. Three databases (EMBASE, PubMed, and MEDLINE) were searched in November 2017 for English-language studies of all levels of evidence that aimed to correlate preoperative MRI measurements of common primary ACL autograft sources to intraoperative measurements of the harvested graft. Two reviewers applied predetermined inclusion/exclusion criteria to independently complete title, abstract, and full-text review of eligible studies. Data abstraction, quality assessment, and descriptive statistics are presented. A systematic screen of 930 titles resulted in 14 studies satisfying inclusion/exclusion criteria. These studies examined 762 patients of mean age 28.6 (9-67) years, with 37.3% females. Comparing the correlation of preoperative MRI measurements to intraoperative harvested measures, the strength was very highly positive for quadriceps tendon (QT) (one study, 29 patients, intraclass correlation coefficient [ICC] = 0.96), highly positive for patellar tendon (two studies, 28 patients, ICC: 0.77-0.87), negligible-highly positive for semitendinosus-only tendon (eight studies, 439 patients, : 0.16-0.81), and negligible-moderately positive for gracilis-only tendon (four studies, 143 patients,: 0.29-0.59). When combined semitendinosus-gracilis tendon grafts were considered, the correlation ranged from low-very highly positive (10 studies, 517 patients, : 0.42-0.93). Preoperative MRI assessment of both QT and bone-patellar tendon-bone autografts most highly correlates with intraoperative measurements of autograft diameter. Considerable variability exists when viewing hamstring tendons either individually or together, where most studies indicate at least a moderate correlation. This highlights the advantage of MRI during the preoperative planning process in equipping the surgeon with a better ability to ensure the diameter of the intended autograft will suffice. This is a Level IV study, systematic review of Levels II to IV studies.

show abstract

Tendon cross‐sectional area on magnetic resonance imaging and anthropometric characteristics can be used to predict insufficient four‐strand hamstring autograft diameter in anterior cruciate ligament reconstruction: A systematic review

Vivekanantha,

Grzela,

Wong

et al. 2024

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

PurposeTo evaluate the utility of semitendinosus tendon (ST) and gracilis tendon (GT) cross‐sectional area (CSA) on magnetic resonance imaging (MRI) and anthropometric characteristics in preoperative estimation of graft diameter in patients undergoing anterior cruciate ligament reconstruction (ACLR) with four‐strand hamstring autografts.MethodsThree databases were searched on 29 August 2023. The authors adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) and R‐AMSTAR (Revised Assessment of Multiple Systematic Review) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Data on demographics, anthropometric characteristics, imaging techniques, tendon CSA, correlation coefficients, sensitivities, specificities, regression models and cutoffs for predicting intraoperative graft diameters above 8 mm were recorded.ResultsForty‐six studies comprising 4140 patients were included. Twelve of 19 (63.2%) studies reporting on ST + GT CSA found a moderate to very high correlation with intraoperative graft diameter. Five of 10 (50%) and one of seven (14.3%) studies reporting on ST CSA and GT CSA, respectively, found a moderate to high correlation with intraoperative graft diameter. Cutoffs of ST + GT CSA for predicting graft diameters above 8 mm ranged from 15.8 to 31.2 mm2. Nine of 35 (25.7%) studies that reported on height found a moderate to very high correlation with graft diameter. Seven of 33 (21.2%) studies reporting on weight found a moderate correlation with graft diameter.ConclusionOf the MRI parameters assessed, ST + GT CSA was the most reliable predictor of graft diameter. However, cutoffs, sensitivities, and specificities for predicting diameters above 8 mm were highly variable. Anthropometric characteristics in general were less predictive of graft diameter than MRI parameters. This information can be used by clinicians to predict patients at risk for ACLR failure due to insufficient graft size.Level of EvidenceLevel IV.

show abstract

Using pre-operative MRI to predict intraoperative hamstring graft size for anterior cruciate ligament reconstruction

Abstract: III.

Cited by 42 publications

References 24 publications

Predictive Factors for Hamstring Autograft Diameter in Anterior Cruciate Ligament Reconstruction

Predictive Factors for Hamstring Autograft Diameter in Anterior Cruciate Ligament Reconstruction

Can Preoperative Magnetic Resonance Imaging Predict Intraoperative Autograft Size for Anterior Cruciate Ligament Reconstruction? A Systematic Review

Tendon cross‐sectional area on magnetic resonance imaging and anthropometric characteristics can be used to predict insufficient four‐strand hamstring autograft diameter in anterior cruciate ligament reconstruction: A systematic review

Contact Info

Product

Resources

About