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Moghamis I, Abuodeh Y, Darwiche A, Ibrahim T, Al Ateeq Al Dosari M, Ahmed G. Anthropometric correlation with hamstring graft size in anterior cruciate ligament reconstruction among males. INTERNATIONAL ORTHOPAEDICS 2020. [PMID: 31879811 DOI: 10.1007/s00264-019-04452-5)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE Pre-operative knowledge of hamstring graft size for anterior cruciate ligament reconstruction (ACL) is of clinical importance and useful in making appropriate decisions about graft choice. This study investigated if there is any correlation between anthropometric measurements such as height, weight, body mass index, thigh length, and circumference with the size of hamstring tendon graft in anterior cruciate ligament reconstruction. METHODS The anthropometric data of 50 consecutive adult males, who underwent primary ACL reconstruction using quadruple hamstring autograft, were collected prospectively. Data analysis using Pearson's correlation test was performed and multiple logistic regression analysis was used to investigate any correlation not detected by Pearson's test and to eliminate confounders. RESULTS Patient's height and thigh length demonstrated a positive correlation with gracilis graft length (r = .464, P = .001, r = .456, P = .001, respectively) and semitendinosus graft length (r = .541, P = 000, r = .578, P = .000, respectively). While the patient's age was the only independent factor which had a positive correlation with the quadrupled hamstring graft diameter (r = .412, P = .004), multiple regression analysis showed abdominal girth had a significant negative correlation with gracilis (P = .04) and semitendinosus (P = .006) graft thickness. CONCLUSION This study demonstrated that some anthropometric measurements had a positive correlation with the hamstring graft length and diameter in male patients. Hence, these results provide preliminary support for the use of some anthropometric measurements in the preoperative planning and prediction of the hamstring graft length and diameter in anterior cruciate ligament reconstruction.
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Affiliation(s)
- Isam Moghamis
- Orthopedics Department, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | - Yousef Abuodeh
- Orthopedics Department, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | - Ali Darwiche
- Orthopedics Department, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | | | | | - Ghalib Ahmed
- Orthopedics Department, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
- Weil Cornell Medical College, Ar-Rayyan, Qatar.
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Moghamis I, Abuodeh Y, Darwiche A, Ibrahim T, Al Ateeq Al Dosari M, Ahmed G. Anthropometric correlation with hamstring graft size in anterior cruciate ligament reconstruction among males. INTERNATIONAL ORTHOPAEDICS 2020; 44:577-584. [PMID: 31879811 PMCID: PMC7026223 DOI: 10.1007/s00264-019-04452-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/11/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Pre-operative knowledge of hamstring graft size for anterior cruciate ligament reconstruction (ACL) is of clinical importance and useful in making appropriate decisions about graft choice. This study investigated if there is any correlation between anthropometric measurements such as height, weight, body mass index, thigh length, and circumference with the size of hamstring tendon graft in anterior cruciate ligament reconstruction. METHODS The anthropometric data of 50 consecutive adult males, who underwent primary ACL reconstruction using quadruple hamstring autograft, were collected prospectively. Data analysis using Pearson's correlation test was performed and multiple logistic regression analysis was used to investigate any correlation not detected by Pearson's test and to eliminate confounders. RESULTS Patient's height and thigh length demonstrated a positive correlation with gracilis graft length (r = .464, P = .001, r = .456, P = .001, respectively) and semitendinosus graft length (r = .541, P = 000, r = .578, P = .000, respectively). While the patient's age was the only independent factor which had a positive correlation with the quadrupled hamstring graft diameter (r = .412, P = .004), multiple regression analysis showed abdominal girth had a significant negative correlation with gracilis (P = .04) and semitendinosus (P = .006) graft thickness. CONCLUSION This study demonstrated that some anthropometric measurements had a positive correlation with the hamstring graft length and diameter in male patients. Hence, these results provide preliminary support for the use of some anthropometric measurements in the preoperative planning and prediction of the hamstring graft length and diameter in anterior cruciate ligament reconstruction.
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Affiliation(s)
- Isam Moghamis
- Orthopedics Department, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | - Yousef Abuodeh
- Orthopedics Department, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | - Ali Darwiche
- Orthopedics Department, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar
| | | | | | - Ghalib Ahmed
- Orthopedics Department, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
- Weil Cornell Medical College, Ar-Rayyan, Qatar.
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El-Sherief FAH, Aldahshan WA, Wahd YE, Abdelaziz AM, Soliman HAG, Hassan TG, Elbehairy HF, Awadallah AH. Double-bundle anterior cruciate ligament reconstruction is better than single-bundle reconstruction in terms of objective assessment but not in terms of subjective score. Knee Surg Sports Traumatol Arthrosc 2018; 26:2395-2400. [PMID: 29159673 DOI: 10.1007/s00167-017-4804-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 11/10/2017] [Indexed: 01/02/2023]
Abstract
PURPOSE A comparison of clinical outcomes between double-bundle (DB) and single-bundle (SB) anterior cruciate ligament (ACL) reconstruction for patients with ACL injury. METHODS Sixty patients were treated with either SB (n = 30) or DB (n = 30) ACL reconstruction between 2011 and 2012. The hamstring tendons were autografted with suspensory fixation on the femoral side, while a bio-absorbable interference screw was used for fixation on the tibial side. These patients were evaluated using Lysholm score, International Knee Documentation Committee (IKDC) forms (both objective and subjective), Lachman test, pivot shift test, and KT 1000 arthrometer. RESULTS After a median follow-up duration of 35.5 months (ranging between 30 and 42 months), the frequency of patients who had high objective IKDC scores was significantly higher in the DB group than those in the SB group. In terms of DB, the Lachman test was normal in 26 patients (86.7%), nearly normal in three patients (10%), and abnormal in one patient (3.3%); comparatively, in terms of SB, the Lachman test was normal in 20 patients (66.7%), nearly normal in eight patients (26.7%) and abnormal in two patients (6.6%). The pivot shift test was negative in 29 patients (96.7%) and 21 patients (70%) for DB and SB, respectively. The average KT-1000 side-to-side difference was 1.0 mm for DB and 1.5 mm for SB. The subjective IKDC and Lysholm score showed non-significant differences between both techniques. CONCLUSION Double-bundle ACL reconstruction was found to have a significant advantage in anterior and rotational stability as well as objective IKDC than that of SB reconstruction. However, subjective measurements showed no statistical differences between the techniques. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Faisal Ahmed Hashem El-Sherief
- Department of Orthopedic Surgery, Faculty of Medicine for Girls, Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt.
| | - Wael Abdelkarim Aldahshan
- Department of Orthopedic Surgery, Faculty of Medicine for Girls, Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt
| | - Yaser Elsayed Wahd
- Department of Orthopedic Surgery, Faculty of Medicine for Girls, Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt
| | - Ashraf Mohamed Abdelaziz
- Department of Orthopedic Surgery, Faculty of Medicine for Girls, Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt
| | - Hany Abdel Gawwad Soliman
- Department of Orthopedic Surgery, Faculty of Medicine for Girls, Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt
| | - Tohamy Goda Hassan
- Department of Orthopedic Surgery, Faculty of Medicine for Girls, Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt
| | - Hassan Fathy Elbehairy
- Department of Orthopedic Surgery, Faculty of Medicine for Girls, Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt
| | - Adel Hamed Awadallah
- Department of Orthopedic Surgery, Faculty of Medicine for Girls, Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt
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Andrei BI, Niculescu M, Popescu G. Position of anterior cruciate ligament after single-bundle arthroscopic reconstruction. INTERNATIONAL ORTHOPAEDICS 2015; 40:393-7. [PMID: 26330084 DOI: 10.1007/s00264-015-2964-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 08/04/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE The goal of this study was to assess the position of the reconstructed anterior cruciate ligament (ACL) in arthroscopic single-bundle ligamentoplasties through an anteromedial portal technique based on a clinical case series of 74 patients followed prospectively. METHODS This cohort study involved 100 patients who underwent arthroscopic ACL reconstruction between January 2012 and January 2014. Patients who underwent isolated ACL reconstruction were selected from 194 cases with associated lesions. Graft placement at the femoral side was within the femoral footprint of ACL. All patients received computed tomography scans and magnetic resonance imaging of both knees to compare ACL graft position to tht of the native ACL in the unaffected knee and to show whether drilling the femoral tunnel through the anteromedial portal closely approximates the native ACL alignment. RESULTS Seventy-four patients were available for follow-up. Mean value for the sagittal angle was 52.6° ± 2.9° for the graft-Blumensaat angle was 4.73° ± 0.75°., closely matching measurements in the contralateral normal knee. CONCLUSION Using the anteromedial portal for single-bundle arthroscopic ACL reconstruction enables graft positioning within the normal footprint and as close as possible to anatomic ACL orientation.
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Affiliation(s)
- Bogdan Ioan Andrei
- Orthopaedics and Traumatology, Clinical Emergency Hospital, Bucharest, Romania
| | - Marius Niculescu
- Titu Maiorescu University, Faculty of Medicine, Colentina Clinical Hospital, Bucharest, Romania.
| | - Gheorghe Popescu
- Orthopaedics and Traumatology, Clinical Emergency Hospital, Bucharest, Romania
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Goyal S, Matias N, Pandey V, Acharya K. Are pre-operative anthropometric parameters helpful in predicting length and thickness of quadrupled hamstring graft for ACL reconstruction in adults? A prospective study and literature review. INTERNATIONAL ORTHOPAEDICS 2015; 40:173-81. [PMID: 26105766 DOI: 10.1007/s00264-015-2818-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 05/29/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Cross-sectional diameter of 7 mm or more of graft in anterior cruciate ligament reconstruction is arguably the single most important factor determining the success of the operation. Pre-operative anthropometric parameters have been reported to correlate with diameter of quadrupled hamstring graft, which is the most popular graft choice today. We conducted this prospective study to determine the value of some anthropometric measurements to predict the length of harvested semitendinosus and gracilis tendons and quadrupled hamstring graft diameter. We also assessed the reliability of the mathematical equation in accurately predicting the graft diameter. METHODS Height, weight, BMI and thigh length of 160 patients who underwent primary ACL reconstruction was measured before surgery. Using multivariate logistic regression analysis length of harvested semitendinous and gracilis tendons along with quadrupled graft diameter were correlated to height, weight, BMI and thigh length. RESULTS Ninety-six percent had graft diameter of 7 mm or more. Height and thigh length were found to be most strongly correlating to both the length of harvested tendons and the quadrupled graft diameter (p ≤ 0.001, r = 0.25-0.39). Patients with height less than 147 cm were found to be at highest risk for inadequate graft diameter (less than 7 mm). Although the anthropometric parameters were found to be significantly related to height and thigh length, the strength of association is moderate. The mathematical equation for prediction of graft diameter using height was found to inaccurately over-predict the graft diameter in 33.1 % of cases, assessed using Bland-Altman plot. CONCLUSION Anthropometric parameters, especially height and thigh length, can serve as a guide to plan hamstring graft diameter and length before ACL reconstruction. But, it is not advisable to rely on mathematical equations for absolute values of graft parameters as there is risk of over-estimating hamstring length or graft thickness.
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Affiliation(s)
| | | | - Vivek Pandey
- Kasturba Medical College, Orthopaedics, Manipal, India
| | - Kiran Acharya
- Kasturba Medical College, Orthopaedics, Manipal, India
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