Correlation between the Length of Gracilis and Semitendinosus Tendon and Physical Parameters in Thai Males
Nitis Reboonlap MD*, Chut Nakornchai MD*, Korakot Charakorn MD*
Affiliation : * Department of Orthopaedics, Phramongkutklao Hospital, Bangkok, Thailand
Background : As anterior cruciate ligament (ACL) injuries became more common, ACL reconstruction using hamstring
tendons autograft (i.e. semitendinosus and gracilis) has become increasingly popular. One of the problems encountered
during operation is insufficient size of the graft.
Objective : In order to determine the size of hamstring graft preoperatively, the authors collect anthropometric data from the
patients and compare them with the actual hamstring tendon length harvested from the patient during ACL reconstruction.
Study
Design : Cross sectional diagnostic study
Material and Method: Seventy-five consecutive patients with torn ACL scheduled for reconstruction using hamstring
autograft were prospectively evaluated. Preoperatively the authors recorded height, weight, body mass index, age, leg length,
thigh length, thigh circumference, length and width of the femur. Intraoperative measurements of both the gracilis and
semitendinosus tendons length were made after trimming the useless thin border of the graft and final diameter of the
quadrupled graft. Bivariate correlation coefficients (Pearson r) were calculated to identify relationships among clinical data
and hamstring graft length and diameter measured intraoperatively.
Results : Strongest correlations for graft lengths were height and leg length measurements from both physical examination
and x-rays. In contrast, graft diameter was not correlated with any physical parameters.
Conclusion : Simple parameter such as height can be used for preoperative identification of patients at risk for insufficient
graft tissue and would be useful for patient counseling and alternative graft source planning. Thai male who is taller than 170
cm have a good potential to have semitendinosus tendon longer than 250 mm and maybe candidates to have ACL reconstruction
with semitendinosus alone. X-ray of the whole leg did not provide any better prediction of graft length.
Keywords : Hamstring, Gracilis, Semitendinosus, Anterior cruciate ligament, Preoperative planning, Hamstring length prediction
