title: Preoperative magnetic resonance imaging evaluation of semitendinosus tendon in anterior cruciate ligament reconstruction: Does this have an effect on graft choice?
abstract: BACKGROUND
  Anterior cruciate ligament (ACL) reconstruction with ST autograft is sometimes unsuccessful because of harvested thin graft. Magnetic resonance imaging (MRI) can be a useful tool to evaluate the thickness of the graft. This study is performed to evaluate whether there is any correlation between diameters and cross-sectional area (CSA) of the semitendinosus tendon (ST) on the preoperative magnetic MRI and the diameter of the 4-stranded ST autograft in ACL reconstruction.
  
  
  METHODS
  Seventy patients who underwent single-bundle ACL reconstruction with 4-stranded ST for full-thickness ACL ruptures were included in this study. Anteroposterior (AP) and mediolateral (ML) diameters of ST at the levels of the joint line (JL) and femoral physeal line (PL), and also CSA at these levels were measured on T2-weighted fat-suppressed MRI examinations. The data obtained were compared with intraoperatively measured diameters of 4-stranded ST autograft. Correlations between variables were evaluated using Spearman's rho. Receiver operating characteristic and area under the curve statistics were used to evaluate the cut-off value for the correlation between 4-stranded ST graft diameter of 8 mm and CSA (mm2) on MRI.
  
  
  RESULTS
  On MRI measurements, no correlation was found between AP diameters at the level of the JL and 4-stranded ST diameter (P= 0.180). However, correlations were found between diameter of 4-stranded ST and ML diameter at the level of JL (P= 0.003) and PL (P= 0.002), AP diameter at the level of the PL (P= 0.009), CSA at the level of the JL (P< 0.001) and at the level of PL (P< 0.001). Correlation between the diameter of 4-stranded ST and CSA at both levels was more significant than that between AP-ML diameters of ST and diameter of autograft. The cut-off value for the 8 mm diameter CSA of 4-stranded ST was 5.9 mm2at the JL and 8.99 mm2at the PL.
  
  
  CONCLUSIONS
  Preoperative MRI evaluation of CSA at the JL of the ST is a reliable parameter to predict graft size. Other graft alternatives should better be considered if the CSA of ST is <5.9 mm2at the level of the JL.
authors.affiliation: Department of Orthopedics and Traumatology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey.
authors.forename: Mutlu
authors.initials: M
authors.lastname: Cobanoglu
authors.affiliation: Department of Orthopedics and Traumatology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey.
authors.forename: Ferit Tufan
authors.initials: FT
authors.lastname: Ozgezmez
authors.affiliation: Department of Biostatistics, Adnan Menderes University Faculty of Medicine, Aydın, Turkey.
authors.forename: Imran Kurt
authors.initials: IK
authors.lastname: Omurlu
authors.affiliation: Department of Orthopedics and Traumatology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey.
authors.forename: Ilhan
authors.initials: I
authors.lastname: Ozkan
authors.affiliation: Department of Orthopedics and Traumatology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey.
authors.forename: Sevki Oner
authors.initials: SO
authors.lastname: Savk
authors.affiliation: Department of Orthopedics and Traumatology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Cullu
keywords: Anterior cruciate ligament; autograft; cross-sectional area of semitendinosus; graft diameter; magnetic resonance imaging; semitendinosus diameter; semitendinosus tendon; sports injuries