title: Posterior single-incision semitendinosus harvest for a quadrupled anterior cruciate ligament graft construct: determination of graft length and diameter based on patient sex, height, weight, and body mass index.
abstract: OBJECTIVE
  This study aimed to determine final graft length and diameter for a quadrupled semitendinosus anterior cruciate ligament (ACL) construct harvested from a single-incision posterior approach with correlation to preoperative patient variables of sex, height, weight, and body mass index (BMI).
  
  
  METHODS
  This was a retrospective review of data collected prospectively on 60 patients undergoing all-inside quadrupled semitendinosus autograft ACL reconstruction.
  
  
  RESULTS
  The mean values of the final quadrupled constructs were a length of 70.3 mm and a diameter of 9.0 mm. Separated based on sex, female versus male final mean graft length was 68.1 mm versus 71.7 mm, and final mean graft diameter was 8.6 mm and 9.3 mm, respectively. In both sexes, patient height and weight were strongly correlated to final construct diameter (r = 0.60 and r = 0.56) and length (r = 0.47 and r = 0.44), respectively.
  
  
  CONCLUSIONS
  A single-incision posterior harvest approach allowed for retrieval of semitendinosis tendon autografts of sufficient dimension to allow for construction of quadrupled ACL grafts of a diameter of 8 mm or more in 95% of cases. In addition, desired graft length was achieved in all cases. Graft dimensions had moderately strong direct correlations to patient height and weight, with significant size differences noted between the sexes. We believe this to be helpful data for surgeons who might consider performing a quadrupled semitendinosus autograft ACL reconstruction.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A.
authors.forename: Clayton W
authors.initials: CW
authors.lastname: Nuelle
authors.affiliation: Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A.
authors.forename: James L
authors.initials: JL
authors.lastname: Cook
authors.affiliation: Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gallizzi
authors.affiliation: Columbia Orthopaedic Group, Columbia, Missouri, U.S.A.. Electronic address: psmithmudoc@aol.com.
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D064592:Autografts; D001837:Body Weights and Measures; D002648:Child; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D055815:Young Adult