, Volkan Kızılkaya 2
, Namık Kemal Kılıccıoglu 1
, 3
, Mustafa Cukurlu 2
, Aydıner Kalacı 1
, Emre Mucahit Kartal 4
2Department of Orthopedics and Traumatology, Mustafa Kemal University Faculty of Medicine, Hatay, Türkiye
3Department of Orthopedics and Traumatology, Private Park Hospital, Adıyaman, Türkiye
4Department of Orthopedics and Traumatology, Antalya City Hospital, Antalya, Türkiye
Abstract
Objective: Accurate preoperative estimation of hamstring tendon graft thickness is crucial for improving the success rates of anterior cruciate ligament (ACL) reconstruction surgeries. Although several imaging methods have been proposed, simple anthropometric measurements may provide a practical and cost-effective alternative. This study aimed to investigate the predictive value of leg length, total body height, and the leg length-to-body height ratio for estimating hamstring graft thickness preoperatively.
Materials and Methods: This retrospective cohort study included 120 patients who underwent ACL reconstruction with quadruple hamstring tendon autografts. Anthropometric measurements, including leg length (measured from the anterior superior iliac spine to the medial malleolus) and total body height, were collected prospectively during follow-up. The correlation between these parameters and intraoperative graft thickness was analyzed using Pearson correlation. Simple and multivariate linear regression analyses were performed to determine predictive factors. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic performance of each parameter for predicting graft thickness ≥8 mm.
Results: Total body height demonstrated the strongest correlation with graft thickness (r=0.52, p<0.001), followed by leg length (r=0.48, p<0.001). Although the leg length-to-body height ratio showed a weak correlation (r=0.40, p=0.003), it was not a statistically significant predictor in the multivariate analysis. ROC analysis showed that total body height had the highest diagnostic accuracy (AUC=0.82, 95% CI: 0.70–0.94) for predicting graft thickness ≥8 mm, with 82.4% sensitivity and 75.0% specificity at a cut-off value of ≥174.0 cm.
Conclusions: Total body height and leg length are reliable preoperative predictors of hamstring tendon graft thickness in ACL reconstruction. Simple anthropometric measurements may help optimize graft selection, reduce the risk of graft failure, and improve surgical outcomes.