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Quadriceps Tendon Autograft in Pediatric ACL Reconstruction: Graft Dimensions and Prediction of Size on Preoperative MRI.

التفاصيل البيبلوغرافية
العنوان: Quadriceps Tendon Autograft in Pediatric ACL Reconstruction: Graft Dimensions and Prediction of Size on Preoperative MRI.
المؤلفون: Baghdadi S; Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., VanEenenaam DP Jr; Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Williams BA; Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Lawrence JTR; Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Maguire KJ; Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Wells L; Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Ganley TJ; Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
المصدر: Orthopaedic journal of sports medicine [Orthop J Sports Med] 2021 Dec 15; Vol. 9 (12), pp. 23259671211056678. Date of Electronic Publication: 2021 Dec 15 (Print Publication: 2021).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Sage on behalf of: The American Orthopaedic Society for Sports Medicine Country of Publication: United States NLM ID: 101620522 Publication Model: eCollection Cited Medium: Print ISSN: 2325-9671 (Print) Linking ISSN: 23259671 NLM ISO Abbreviation: Orthop J Sports Med Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Thousand Oaks, CA] : Sage on behalf of: The American Orthopaedic Society for Sports Medicine, [2013]-
مستخلص: Background: There is increased interest in quadriceps autograft anterior cruciate ligament (ACL) reconstruction in the pediatric population.
Purpose: To evaluate children and adolescents who underwent ACL reconstruction using a quadriceps autograft to determine the properties of the harvested graft and to assess the value of demographic, anthropometric, and magnetic resonance imaging (MRI) measurements in predicting the graft size preoperatively.
Study Design: Cross-sectional study; Level of evidence, 3.
Methods: A retrospective database search was performed from January 2018 through October 2020 for patients undergoing ACL reconstruction. Patients <18 years old at the time of surgery in whom a quadriceps tendon autograft was used were selected. Demographic data and anthropometric measurements were recorded, and graft measurements were abstracted from the operative notes. Knee MRI scans were reviewed to measure the quadriceps tendon thickness on sagittal cuts. Graft length and diameter were then correlated with anthropometric and radiographic data.
Results: A total of 169 patients (98 male) were included in the final analysis, with a median age of 15 years (range, 9-17 years). A tendon length ≥65 mm was harvested in 159 (94%) patients. The final graft diameter was 8.4 ± 0.7 mm (mean ± SD; range, 7-11 mm). All patients had a graft diameter ≥7 mm, and 139 (82%) had a diameter ≥8 mm. Preconditioning decreased the graft diameter by a mean 0.67 ± 0.23 mm. Age ( P = .04) and quadriceps thickness on MRI ( P = .003) were significant predictors of the final graft diameter. An MRI sagittal thickness >6.7 mm was 97.4% sensitive for obtaining a graft ≥8 mm in diameter.
Conclusion: Our findings suggest that tendon-only quadriceps autograft is a reliable graft source in pediatric ACL reconstruction, yielding a graft diameter ≥8 mm in 82% of pediatric patients. Furthermore, preoperative MRI measurements can be reliably used to predict a graft of adequate diameter in children and adolescents undergoing ACL reconstruction, with a sagittal thickness >6.7 mm being highly predictive of a final graft size ≥8 mm.
Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: B.A.W. has received education payments from Arthrex and hospitality payments from K2 M. J.T.R.L. has received education payments from Arthrex and royalties from Sawbones/Pacific Research Laboratories. K.J.M. has received education payments from Arthrex and Smith & Nephew. L.W. has received speaking fees from Synthes GmbH. T.J.G. has received research support from AlloSource, Arthrex, and Vericel and education payments from Arthrex and is a paid associate editor for The American Journal of Sports Medicine. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
(© The Author(s) 2021.)
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فهرسة مساهمة: Keywords: anterior cruciate ligament; hamstring autograft; pediatric sports medicine; quadriceps autograft; reconstruction
تواريخ الأحداث: Date Created: 20211224 Latest Revision: 20220429
رمز التحديث: 20240829
مُعرف محوري في PubMed: PMC8689610
DOI: 10.1177/23259671211056678
PMID: 34950742
قاعدة البيانات: MEDLINE
الوصف
تدمد:2325-9671
DOI:10.1177/23259671211056678