Abstract
Purpose
This study was undertaken primarily to identify the tibial insertion site length of ruptured ACL fibres in patients undergoing primary ACL reconstruction. A secondary aim was to evaluate the correlation of pre- and intra-operative measurements.
Methods
In 146 patients undergoing primary ACL reconstruction, a preoperative measurement on MRI of the tibial ACL insertion site length was taken by two raters and then compared with single surgeon’s intra-operative measurements using a specialized ruler. Inclusion criteria were primary ACL reconstruction and MRI performed within 3 months prior to surgery on one specific MRI machine at the study centre. Inter-rater and intra-rater reliability based on intra class correlation (ICC) was calculated. Additionally, correlation between preoperative and postoperative measurements and the anthropometric data was assessed using Pearson correlation.
Results
The tibial ACL insertion site had a mean length of 16.6 ± 1.6 mm (11.9–21.0) as measured by MRI, and 16.4 ± 1.6 mm (11.0–20.0) as measured intra-operatively. The ICCs for intra- and inter-rater reliability of the MRI measurements were 0.99 (95 % CI 0.97; 0.99; p < 0.001) and 0.81 (95 % CI 0.75; 0.86; p < 0.001), respectively. Regression analysis demonstrated, after controlling for subject height and weight, that the MRI measurements significantly predicted intra-operative measurement of tibial insertion site length (β = 0.796; R 2-change 0.77; p < 0.001).
Conclusion
Preoperative measurement of the tibial ACL length is possible using MRI and can be a valuable aid in more efficient preoperative planning given the knowledge of expected dimensions of special knee structures.
Level of evidence
III.
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Acknowledgments
The authors would like to thank Yihe Huang, from the Department of Orthopaedic Surgery, University of Pittsburgh Medical Center for statistical analysis. There was no funding for this study.
Conflict of interest
The authors declare that they have no potential conflicts of interest, related to the presented work.
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Widhalm, H.K., Surer, L., Kurapati, N. et al. Tibial ACL insertion site length: correlation between preoperative MRI and intra-operative measurements. Knee Surg Sports Traumatol Arthrosc 24, 2787–2793 (2016). https://doi.org/10.1007/s00167-014-3473-8
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DOI: https://doi.org/10.1007/s00167-014-3473-8