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Preoperative ultrasound predicts the intraoperative diameter of the quadriceps tendon autograft more accurately than preoperative magnetic resonance imaging for anterior cruciate ligament reconstruction

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Sizing of potential autografts is essential to match the native anterior cruciate ligament (ACL) dimensions when performing ACL reconstruction (ACLR). We aimed to investigate the accuracy and reliability of the thickness and cross-sectional area (CSA) assessments for the prediction of the intraoperative diameter of the QT autograft using preoperative ultrasound and MRI.

Methods

Thirty patients (mean age ± standard deviation, 19.9 ± 5.0 years), who underwent ACLR using QT autograft, were included. The maximum thickness of the QT was assessed at 15 and 30 mm proximal using ultrasound with a long axis image, and at 15 mm proximal to the superior pole of the patella using MRI with a sagittal image. The CSA was assessed at the central 10 mm of the medial–lateral QT width at 30 mm proximal using ultrasound with a short axis image, and at 15 mm proximal to the superior pole of the patella using MRI with an axial image. Intraoperatively, QT autograft was harvested with a 10 mm width and the diameter was measured using a graft sizing device.

Results

Intra- and inter-observer reliabilities of all measurements using ultrasound and MRI were good (Intra-class correlation coefficient, 0.720–0.941). Correlation coefficient with the intraoperative diameter of the QT autograft was higher in ultrasound (R = 0.738–0.791, P < 0.001) than MRI (R = 0.449–0.543, P = 0.002–0.013).

Conclusions

Preoperative ultrasound predicted the intraoperative diameter of the QT autograft more accurately than MRI. Ultrasound may be used clinically to assure a sufficiently large QT autograft diameter to match the diameter of the patient’s native ACL.

Level of evidence

Level III.

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Data availability

The datasets during and/or analyzed during the current study available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA

    Satoshi Takeuchi, Benjamin B. Rothrauff, Masashi Taguchi, Kentaro Onishi & Freddie H. Fu

  2. Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA

    Kentaro Onishi

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  1. Satoshi Takeuchi
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  2. Benjamin B. Rothrauff
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  3. Masashi Taguchi
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  4. Kentaro Onishi
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  5. Freddie H. Fu
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Correspondence to Freddie H. Fu.

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The study was approved by the Institutional Review Board of our institution (STUDY19100047).

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Informed consent was obtained from all individual participants included in the study.

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Takeuchi, S., Rothrauff, B.B., Taguchi, M. et al. Preoperative ultrasound predicts the intraoperative diameter of the quadriceps tendon autograft more accurately than preoperative magnetic resonance imaging for anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 30, 52–60 (2022). https://doi.org/10.1007/s00167-020-06408-4

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