Predicting the Hamstring Graft Size for ACL Reconstruction Using a 3D Tendon Model in Preoperative MRI

Area of Science:

• Orthopedic Surgery
• Radiology
• Biomedical Engineering

Background:

• Anterior cruciate ligament (ACL) ruptures are common in athletes.
• Accurate graft diameter estimation is crucial for ACL reconstruction surgery.
• Magnetic resonance imaging (MRI) offers a potential method for pre-operative graft assessment.

Purpose of the Study:

• To evaluate the reliability of MRI-based 3D segmentation of hamstring tendons for estimating graft diameter.
• To determine the optimal MRI segment for predicting graft size.
• To correlate pre-operative MRI measurements with intra-operative graft diameter.

Main Methods:

• Retrospective analysis of 32 patients undergoing ACL reconstruction.
• 3D segmentation of gracilis tendon (GT) and semitendinosus tendon (ST) using MRI.
• Calculation of cross-sectional area (CSA) across six specific tendon segments.
• Correlation of mean CSA with surgically measured graft diameter.

Main Results:

• Significant correlation found between hamstring tendon CSA and graft diameter across all segments.
• The 10 mm-0 mm segment above the joint line demonstrated the strongest correlation (r = 0.552).
• Observed differences in CSA between male and female patients.

Conclusions:

• MRI-based 3D segmentation of ST and GT provides a reliable method for pre-operative graft diameter estimation.
• The 10 mm-0 mm segment is an ideal reference point for graft planning in ACL reconstruction.
• This technique aids in optimizing surgical outcomes by ensuring appropriate graft size.