Role of anthropometric data in the prediction of 4-stranded hamstring graft size in anterior cruciate ligament reconstruction

Published online: Mar 27 2016

Sean Wei Loong HO, Teong Jin Lester TAN, Keng Thiam Lee

From the Department of Orthopaedic Surgery, Tan Tock Seng Hospital


To evaluate whether pre-operative anthropometric data can predict the optimal diameter and length of hamstring tendon autograft for anterior cruciate ligament (ACL) reconstruction. This was a cohort study that involved 169 patients who underwent single-bundle ACL reconstruction (single surgeon) with 4-stranded MM Gracilis and MM Semi-Tendinosus autografts. Height, weight, body mass index (BMI), gender, race, age and smoking status were recorded pre-operatively. Intraoperatively, the diameter and functional length of the 4-stranded autograft was recorded. Multiple regression analysis was used to determine the relationship between the anthropometric measurements and the length and diameter of the implanted autografts. The strongest correlation between 4-stranded hamstring autograft diameter was height and weight. This correlation was stronger in females than males. BMI had a moderate correlation with the diameter of the graft in females. Females had a significantly smaller graft both in diameter and length when compared with males. Linear regression models did not show any significant correlation between hamstring autograft length with height and weight (p > 0.05). Simple regression analysis demonstrated that height and weight can be used to predict hamstring graft diameter. The following regression equation was obtained for females : Graft diameter = 0.012 + 0.034*Height + 0.026*Weight (R2 = 0.358, p = 0.004) The following regression equation was obtained for males : Graft diameter = 5.130 + 0.012*Height + 0.007*Weight (R2 = 0.086, p = 0.002). Pre-operative anthropometric data has a positive correlation with the diameter of 4 stranded hamstring autografts but no significant correlation with the length. This data can be utilised to predict the autograft diameter and may be useful for pre-operative planning and patient counseling for graft selection.