Investigating the Magnetic Resonance Imaging Cross-sectional Area That Best Correlates with Intraoperative Hamstring...

Area of Science:

• Orthopedic Surgery
• Radiology
• Biomedical Engineering

Background:

• Hamstring tendon autografts are common for anterior cruciate ligament (ACL) reconstruction.
• Preoperative estimation of hamstring graft diameter is challenging.
• Magnetic resonance imaging (MRI)-based cross-sectional area (CSA) is used to assess graft size.

Purpose of the Study:

• To identify the MRI-based CSA measurement level that best correlates with intraoperative hamstring autograft diameter.
• To enhance preoperative graft size prediction for ACL reconstruction.

Main Methods:

• Prospective observational study of 41 patients (aged 20-45) undergoing ACL reconstruction.
• MRI CSA of semitendinosus and gracilis tendons measured at anteroposterior (AP) and joint line levels.
• Correlation analysis (Pearson, Spearman) between MRI CSA and intraoperative graft diameter.

Main Results:

• Mean AP CSA (19.63 mm²) was greater than joint line CSA (16.55 mm²).
• AP CSA demonstrated the strongest correlation with intraoperative graft diameter (r = 0.858, P < 0.001).
• Joint line CSA showed a moderate correlation (r = 0.625). Average intraoperative graft diameter was 8.48 mm.

Conclusions:

• MRI-based CSA measurement at the AP level is a reliable, noninvasive predictor of hamstring graft diameter.
• This method aids in surgical planning and predicting graft sufficiency for ACL reconstruction.