Skip to main content
Log in

Is height the best predictor for adequacy of semitendinosus-alone anterior cruciate ligament reconstruction? A study of hamstring graft dimensions and anthropometric measurements

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

To predict adequacy of semitendinosus (ST) graft dimension for ACLR from anthropometric measures.

Introduction

Single tendon harvest for autograft hamstring ACLR could be beneficial to limit donor site morbidity; however, concerns for reconstruction failure based upon inadequate graft size may limit this surgical technique.

Methodology

To predict adequacy, prospectively, 108 patients who underwent ACLR by hamstring graft (STG graft) were enrolled for the study. Mean age was 33.028 years ± 9.539 SD (14–59) with 88 males and 20 females. Anthropometric measurements (height, weight, BMI, thigh and total limb length) and intraoperative data (graft dimensions and bone tunnel measurements) were collected for analysis. Semitendinosus graft can be used as 3-strand (ST3) or 4-strand (ST4) graft. Adequacy criteria for ST3 and ST4 graft dimensions were determined from data analysis. SPSS (v.17) Pearson’s correlation coefficient and ROC curves were used for statistical analyses.

Results

A total of 74 out of 108 patients (68.52 %) had adequate graft dimensions for ST3 reconstruction. Height equal or greater than 158 cm was predictive of adequate graft for ST3 reconstruction. Only 23 patients (21.3 %) had adequate graft dimensions for ST4 reconstruction. Height equal or greater than 170 cm was predictive of adequate graft for ST4 reconstruction. Height variable had the highest ROC curve area of 0.840 and 0.910 for both ST3 graft and ST4 graft, respectively. Hence, height was used as best predictor to determine adequacy of the graft.

Conclusion

Height can be predictive of adequate graft for single tendon ACL reconstruction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Marcacci M, Zaffagnini S, Iacono F et al (2003) Intra- and extraarticular anterior cruciate ligament reconstruction utilizing autogeneous semitendinosus and gracilis tendons: 5-Year clinical results. Knee Surg Sports Traumatol Arthrosc 11(1):2–8

    PubMed  Google Scholar 

  2. Howell SM, Deutsch ML (1999) Comparison of endoscopic and two-incision techniques for reconstructing a torn anterior cruciate ligament using hamstring tendons. Arthroscopy 15(6):594–606

    Article  CAS  PubMed  Google Scholar 

  3. Beynnon BD, Johnson RJ, Fleming BC et al (2002) Anterior cruciate ligament replacement: comparison of bonepatellar tendon-bone grafts with two-strand hamstring grafts: a prospective, randomized study. J Bone Joint Surg 84(9):1503–1513

    PubMed  Google Scholar 

  4. Gobbi A, Tuy B, Panuncialman I, Mahajan S (2003) Quadrupled bone-semitendinosus anterior cruciate ligament reconstruction: a clinical investigation in a group of athletes. Arthroscopy 19(7):691–699

    Article  PubMed  Google Scholar 

  5. Cooley V, Deffner K, Rosenberg T (2001) Quadrupled semitendinosus anterior cruciate ligament reconstruction: 5-Year results in patients without meniscus loss. Arthroscopy 17(8):795–800

    Article  CAS  PubMed  Google Scholar 

  6. Goradia V, Grana W (2001) A comparison of outcomes at 2 to 6 years after acute and chronic anterior cruciate ligament reconstructions using hamstring tendon grafts. Arthroscopy 17(4):383–392

    Article  CAS  PubMed  Google Scholar 

  7. Tashiro T, Kurosawa H, Kawakami A, Hikita A, Fukui N (2003) Influence of medial hamstring tendon harvest on knee flexor strength after anterior cruciate ligament reconstruction. A detailed evaluation with comparison of single-and double-tendon harvest. Am J Sports Med 31(4):522–529

    Article  PubMed  Google Scholar 

  8. Gobbi A (2010) Single versus double hamstring tendon harvest for ACL reconstruction. Sports Med Arthrosc 18(1):15–19

    Article  PubMed  Google Scholar 

  9. Segawa H, Omori G, Koga Y et al (2002) Rotational muscle strength of the limb in anterior cruciate ligament reconstruction using semitendinosus and gracilis tendon. Arthroscopy 18(2):177–182

    Article  PubMed  Google Scholar 

  10. Ardern CL, Webster KE, Taylor NF, Feller JA (2010) Hamstring strength recovery after hamstring tendon harvest for anterior cruciate ligament reconstruction: a comparison between graft types. Arthroscopy 26(4):462–469

    Article  PubMed  Google Scholar 

  11. Tuman JM, Diduch DR, Rubino LJ, Baumfeld JA, Nguyen HS, Hart JM (2007) Predictors for hamstring graft diameter in anterior cruciate ligament reconstruction. Am J Sports Med 35:1945–1949

    Article  PubMed  Google Scholar 

  12. Treme G, Diduch DR, Billante MJ, Miller MD, Hart JM (2008) Hamstring graft size prediction: a prospective clinical evaluation. Am J Sports Med 36:2204–2209

    Article  PubMed  Google Scholar 

  13. Schwartzberg R, Burkhart B, Lariviere C (2008) Prediction of hamstring tendon autograft diameter and length for anterior cruciate ligament reconstruction. Am J Orthop 37:157–159

    PubMed  Google Scholar 

  14. Barenius B, Webster WK, McClelland J, Feller J (2013) Hamstring tendon anterior cruciate ligament reconstruction: does gracilis tendon harvest matter? Int Orthop 37:207–212

    Article  PubMed  PubMed Central  Google Scholar 

  15. Noyes FR, Butler DL, Grood ES, Zernicke RF, Hefzy MS (1984) Biomechanical analysis of human ligament grafts used in kneeligament repairs and reconstructions. J Bone Joint Surg Am 66(3):344–352

    CAS  PubMed  Google Scholar 

  16. Grood ES, Walz-Hasselfeld KA, Holden JP et al (1992) The correlation between anterior-posterior translation and crosssectional area of anterior cruciate ligament reconstructions. J Orthop Res 10(6):878–885

    Article  CAS  PubMed  Google Scholar 

  17. Hamada M, Shino K, Horibe S, Mitsuoka T, Toritsuka Y, Nakamura N (2005) Changes in cross-sectional area of hamstring anterior cruciate ligament grafts as a function of time following transplantation. Arthroscopy 21(8):917–922

    Article  PubMed  Google Scholar 

  18. Gobbi A (2007) Double bundle ACL reconstruction using only the semitendinosus. ISAKOS Current concepts, Winter

  19. Gobbi A, Francisco R (2005) Quadruple semitendinosus tendon for anterior cruciate ligament reconstruction. Tech Orthop 20(3):203–206

    Article  Google Scholar 

  20. Singhal MC, Johnson DL, Fites BS (2005) Fixation devices in ACL surgery: what do I need to know? Orthopedics 28(9):920–4

    PubMed  Google Scholar 

  21. Brand J Jr, Weiler A, Caborn DN, Brown CH Jr, Johnson DL (2000) Graft fixation in cruciate ligament reconstruction. Am J Sports Med 28:761–774

    PubMed  Google Scholar 

  22. Prodromos C (2007) The anterior cruciate ligament reconstruction and basic science. 2ST/2Gr, 4ST, and 3ST/2Gr techniques: deciding which hamstring configuration to use. Saunders, New York, pp 110–114

Download references

Conflict of interest

No conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ramakanth Rajagopalakrishnan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sundararajan, S.R., Rajagopalakrishnan, R. & Rajasekaran, S. Is height the best predictor for adequacy of semitendinosus-alone anterior cruciate ligament reconstruction? A study of hamstring graft dimensions and anthropometric measurements. International Orthopaedics (SICOT) 40, 1025–1031 (2016). https://doi.org/10.1007/s00264-015-2882-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-015-2882-8

Keywords

Navigation