Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Sep;50(5):499-504.
doi: 10.4103/0019-5413.189612.

Preoperative magnetic resonance imaging evaluation of semitendinosus tendon in anterior cruciate ligament reconstruction: Does this have an effect on graft choice?

Mutlu Cobanoglu  1 , Ferit Tufan Ozgezmez  1 , Imran Kurt Omurlu  2 , Ilhan Ozkan  1 , Sevki Oner Savk  1 , Emre Cullu  1
Affiliations

Preoperative magnetic resonance imaging evaluation of semitendinosus tendon in anterior cruciate ligament reconstruction: Does this have an effect on graft choice?

Mutlu Cobanoglu et al. Indian J Orthop. 2016 Sep.

Abstract

Background: Anterior cruciate ligament (ACL) reconstruction with ST autograft is sometimes unsuccessful because of harvested thin graft. Magnetic resonance imaging (MRI) can be a useful tool to evaluate the thickness of the graft. This study is performed to evaluate whether there is any correlation between diameters and cross-sectional area (CSA) of the semitendinosus tendon (ST) on the preoperative magnetic MRI and the diameter of the 4-stranded ST autograft in ACL reconstruction.

Materials and methods: Seventy patients who underwent single-bundle ACL reconstruction with 4-stranded ST for full-thickness ACL ruptures were included in this study. Anteroposterior (AP) and mediolateral (ML) diameters of ST at the levels of the joint line (JL) and femoral physeal line (PL), and also CSA at these levels were measured on T2-weighted fat-suppressed MRI examinations. The data obtained were compared with intraoperatively measured diameters of 4-stranded ST autograft. Correlations between variables were evaluated using Spearman's rho. Receiver operating characteristic and area under the curve statistics were used to evaluate the cut-off value for the correlation between 4-stranded ST graft diameter of 8 mm and CSA (mm2) on MRI.

Results: On MRI measurements, no correlation was found between AP diameters at the level of the JL and 4-stranded ST diameter (P = 0.180). However, correlations were found between diameter of 4-stranded ST and ML diameter at the level of JL (P = 0.003) and PL (P = 0.002), AP diameter at the level of the PL (P = 0.009), CSA at the level of the JL (P < 0.001) and at the level of PL (P < 0.001). Correlation between the diameter of 4-stranded ST and CSA at both levels was more significant than that between AP-ML diameters of ST and diameter of autograft. The cut-off value for the 8 mm diameter CSA of 4-stranded ST was 5.9 mm2 at the JL and 8.99 mm2 at the PL.

Conclusion: Preoperative MRI evaluation of CSA at the JL of the ST is a reliable parameter to predict graft size. Other graft alternatives should better be considered if the CSA of ST is <5.9 mm2 at the level of the JL.

Keywords: Anterior cruciate ligament; autograft; cross-sectional area of semitendinosus; graft diameter; magnetic resonance imaging; semitendinosus diameter; semitendinosus tendon; sports injuries.

PubMed Disclaimer

Figures

Figure 1
Figure 1
MRI axial and sagittal views T2W fat suppressed showing (a) Semitendinosus tendon, marked at the level of the joint line, (b) Semitendinosus tendon, marked at the level of physeal line
Figure 2
Figure 2
On T2-weighted fat-suppressed axial magnetic resonance imaging showing (a) Measurements of anteroposterior and mediolateral diameters of semitendinosus tendon at the level of the joint line. (b) Measurement of cross-sectional area of semitendinosus tendon at the level of the joint line (×10)
Figure 3
Figure 3
Receiver operating characteristic analysis
See this image and copyright information in PMC

References

    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;20:1293–7. - PubMed
    1. Magnussen RA, Lawrence JT, West RL, Toth AP, Taylor DC, Garrett WE. Graft size and patient age are predictors of early revision after anterior cruciate ligament reconstruction with hamstring autograft. Arthroscopy. 2012;28:526–31. - PubMed
    1. Maeda A, Shino K, Horibe S, Nakata K, Buccafusca G. Anterior cruciate ligament reconstruction with multistranded autogenous semitendinosus tendon. Am J Sports Med. 1996;24:504–9. - PubMed
    1. Conte EJ, Hyatt AE, Gatt CJ, Jr, Dhawan A. Hamstring autograft size can be predicted and is a potential risk factor for anterior cruciate ligament reconstruction failure. Arthroscopy. 2014;30:882–90. - PubMed
    1. Ma CB, Keifa E, Dunn W, Fu FH, Harner CD. Can preoperative measures predict quadruple hamstring graft diameter? Knee. 2010;17:81–3. - PubMed