Prediction of Semitendinosus Graft Length and Girth using Anthropometric Parameters: A Prospective Study in North Kerala Population

Abstract

Introduction: Semitendinosus, Gracilis and Bone-Patellar Tendon-Bone (BPTB) graft are the most popular grafts for Anterior Cruciate Ligament (ACL) reconstruction. Although bone-to-bone patellar tendon grafting improves knee stability and healing rates, there are drawbacks, including donor site morbidity, patellar tendinopathy, anterior knee pain, flexion contracture, and patellar fracture. The advantages of semitendinosus graft include preservation of bone stock, the ability to triple graft length when needed, and the ability to take Gracilis graft through the same incision if graft diameter is too small. Aim: To predict the semitendinosus graft length and diameter using anthropometric parameters (height, weight, Body Mass Index (BMI), waist circumference, thigh circumference and thigh length). Materials and Methods: This prospective descriptive study was conducted in the Department of Orthopaedics, Malabar Medical College, Calicut, Kerala, India for a period of one year (from October 2021 to October 2022). A total of 50 patients in the age group 15-60 years with ACL insufficiency planned for hamstring autograft reconstruction were examined. A number of preoperative factors, including age, gender, height, weight, BMI, thigh length, thigh circumference and waist circumference were assessed. A 2-tailed test and Pearson correlation was used to identify relationships between outcome variables (semitendinosus graft length and quadrupled tendon diameter) and predictor variables (age, gender, height, weight, BMI, thigh length, thigh circumference and waist circumference). Results: A total of 68% of patients had a semitendinosus graft diameter ≥8 mm, while 32% percent were <8 mm. Compared to males, females had a lower body weight and height and their hamstring grafts were shorter with smaller diameter. Correlation analysis indicated that there was a significant positive relation between height and weight on graft length and diameter (p<0.005). Conclusion: The study concluded that both hamstring diameter and length was related to height and weight of the person. Patients who were taller and heavier might be anticipated to have grafts with longer length and larger diameter. Also, thigh and waist parameters had no impact on hamstring tendon size.