title: The sizing of hamstring grafts for anterior cruciate reconstruction: intra- and inter-observer reliability.
abstract: OBJECTIVE
  The objective of this study was to establish the intra- and inter-observer reliability of hamstring graft measurement using cylindrical sizing tubes.
  
  
  METHODS
  Hamstring tendons (gracilis and semitendinosus) were harvested from ten cadavers by a single surgeon and whip stitched together to create ten 4-strand hamstring grafts. Ten sports medicine surgeons and fellows sized each graft independently using either hollow cylindrical sizers or block sizers in 0.5-mm increments—the sizing technique used was applied consistently to each graft. Surgeons moved sequentially from graft to graft and measured each hamstring graft twice. Surgeons were asked to state the measured proximal (femoral) and distal (tibial) diameter of each graft, as well as the diameter of the tibial and femoral tunnels that they would drill if performing an anterior cruciate ligament (ACL) reconstruction using that graft. Reliability was established using intra-class correlation coefficients.
  
  
  RESULTS
  Overall, both the inter-observer and intra-observer agreement were >0.9, demonstrating excellent reliability. The inter-observer reliability for drill sizes was also excellent (>0.9). Excellent correlation was seen between cylindrical sizing, and drill sizes (>0.9).
  
  
  CONCLUSIONS
  Sizing of hamstring grafts by multiple surgeons demonstrated excellent intra-observer and intra-observer reliability, potentially validating clinical studies exploring ACL reconstruction outcomes by hamstring graft diameter when standard techniques are used.
  
  
  METHODS
  III.
authors.forename: Tim
authors.initials: T
authors.lastname: Dwyer
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Whelan
authors.forename: Amir
authors.initials: A
authors.lastname: Khoshbin
authors.forename: David
authors.initials: D
authors.lastname: Wasserstein
authors.forename: Andrew
authors.initials: A
authors.lastname: Dold
authors.forename: Jaskarndip
authors.initials: J
authors.lastname: Chahal
authors.forename: Aaron
authors.initials: A
authors.lastname: Nauth
authors.forename: M Lucas
authors.initials: ML
authors.lastname: Murnaghan
authors.forename: Darrell J
authors.initials: DJ
authors.lastname: Ogilvie-Harris
authors.forename: John S
authors.initials: JS
authors.lastname: Theodoropoulos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D013710:Tendons / Q000033:anatomy & histology* / Q000637:transplantation*