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. 2022 Sep;56(5):311-315.
doi: 10.5152/j.aott.2022.21183.

Investigating the magnetic resonance imaging cross-section area that best correlates with intraoperative hamstring autograft size

Tacettin Ayanoğlu  1 , Emre Arıkan  2 , Onur Yılmaz  1 , Halil Gökkuş  3 , Yasin Emre Kaya  1 , Kutay Engin Özturan  1
Affiliations

Investigating the magnetic resonance imaging cross-section area that best correlates with intraoperative hamstring autograft size

Tacettin Ayanoğlu et al. Acta Orthop Traumatol Turc. 2022 Sep.

Abstract

Objective: This study aimed to find out the level of the gracilis and semitendinosus tendons that would provide the closest information about the size of the quadruple-stranded hamstring autograft using magnetic resonance images before anterior cruciate ligament reconstruction.

Methods: Ninety-six patients (44 males, 52 females) who underwent anterior cruciate ligament reconstruction with quadruple hamstring tendon autografts between January 2015 and March 2020 were retrospectively analyzed. The cross-sectional areas of the gracilis and the semitendinosus tendons at 6 different levels (pes anserinus insertion site, tibial tuberosity, fibular head, tibial plateau, and the proximal insertion sites of the anterior cruciate ligament and the medial collateral ligament were measured on the magnetic resonance images. In addition, the harvested hamstring tendons were measured together (quadrupled) using a standardized graft-sizing block.

Results: There was no significant difference between genders in terms of the tendon sizes measured in all levels using magnetic resonance images. There was a strong correlation between the graft size and the measurements made at the tibial plateau level (P < .0001, r=0.590).

Conclusion: Intraoperative quadruple hamstring tendon sizes were most correlated with the magnetic resonance image measurements at the tibial plateau level. To use a hamstring autograft with a diameter of at least 8 mm for anterior cruciate ligament reconstruction, the total area of the 2 tendons should be at least 18.11 mm2 in the magnetic resonance image measurements made at the tibial plateau level.

Level of evidence: Level IV, Diagnostic Study.

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Figures

Figure 1.
Figure 1.
The six different levels used in cross-sectional area measurements.
Figure 2.
Figure 2.
Axial proton density-weighted MRI of the knee analyzed at 300% magnificationusing the ImageJ software. At the level of the proximal MCL insertion site, the cross-sectional area measurements of the gracilis (1) and the semitendinosus (2) tendons were 8.890 mm and 12.093 mm, respectively.
See this image and copyright information in PMC

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