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Effect of Patient Height and Sex on the Patellar Tendon and Anterior Cruciate Ligament

BACKGROUND: Graft-tunnel mismatch is an avoidable complication in anterior cruciate ligament (ACL) reconstruction. Patient height and sex may be predictors of patellar tendon length (PTL) and intra-articular ACL length (IAL). Understanding these relationships may assist in reducing graft-tunnel mism...

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Autores principales: Campbell, Abigail L., Caldwell, Jon-Michael E., Yalamanchili, Dheeraj, Sepanek, Lia, Youssefzadeh, Keon, Uquillas, Carlos A., Limpisvasti, Orr
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8114262/
https://www.ncbi.nlm.nih.gov/pubmed/34017879
http://dx.doi.org/10.1177/23259671211003244
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author Campbell, Abigail L.
Caldwell, Jon-Michael E.
Yalamanchili, Dheeraj
Sepanek, Lia
Youssefzadeh, Keon
Uquillas, Carlos A.
Limpisvasti, Orr
author_facet Campbell, Abigail L.
Caldwell, Jon-Michael E.
Yalamanchili, Dheeraj
Sepanek, Lia
Youssefzadeh, Keon
Uquillas, Carlos A.
Limpisvasti, Orr
author_sort Campbell, Abigail L.
collection PubMed
description BACKGROUND: Graft-tunnel mismatch is an avoidable complication in anterior cruciate ligament (ACL) reconstruction. Patient height and sex may be predictors of patellar tendon length (PTL) and intra-articular ACL length (IAL). Understanding these relationships may assist in reducing graft-tunnel mismatch during ACL reconstruction with bone–patellar tendon–bone (BTB) autograft. PURPOSE: To determine the association of patient height and sex with PTL and IAL. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Magnetic resonance imaging (MRI) studies were obtained on the healthy knees of 100 male and 100 female patients. Patients with prior surgery, open physes, significant degenerative changes, ACL rupture, or extensor mechanism injury were excluded. Three independent readers measured PTL, IAL, and Caton-Deschamps Index (CDI) on MRI. Bivariate and linear regression analysis was performed to detect the association of anthropometric data with anatomic parameters measured on MRI studies. RESULTS: The mean age and body mass index were not significantly different between the male and female patients; however, male patients were significantly taller than female patients (1.75 vs 1.72 m, respectively; P < .001). There was a substantial agreement between the 3 readers for all parameters (κ > 0.75). Overall, female patients had significantly longer PTL (47.38 vs 43.92 mm), higher CDI (1.146 vs 1.071), and shorter IAL (33.05 vs 34.39 mm) (P < .001 for all). Results of the linear regression analysis demonstrated that both height and female sex were predictive of longer PTL. Further, height was independently predictive of IAL but sex was not. CONCLUSION: PTL was correlated more with patient sex than height. IAL was also correlated with patient sex. Longer BTB grafts are expected to be harvested in female patients compared with male patients of the same height despite shorter IAL. These associations should be considered during BTB ACL reconstruction to minimize graft-tunnel mismatch.
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spelling pubmed-81142622021-05-19 Effect of Patient Height and Sex on the Patellar Tendon and Anterior Cruciate Ligament Campbell, Abigail L. Caldwell, Jon-Michael E. Yalamanchili, Dheeraj Sepanek, Lia Youssefzadeh, Keon Uquillas, Carlos A. Limpisvasti, Orr Orthop J Sports Med Article BACKGROUND: Graft-tunnel mismatch is an avoidable complication in anterior cruciate ligament (ACL) reconstruction. Patient height and sex may be predictors of patellar tendon length (PTL) and intra-articular ACL length (IAL). Understanding these relationships may assist in reducing graft-tunnel mismatch during ACL reconstruction with bone–patellar tendon–bone (BTB) autograft. PURPOSE: To determine the association of patient height and sex with PTL and IAL. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Magnetic resonance imaging (MRI) studies were obtained on the healthy knees of 100 male and 100 female patients. Patients with prior surgery, open physes, significant degenerative changes, ACL rupture, or extensor mechanism injury were excluded. Three independent readers measured PTL, IAL, and Caton-Deschamps Index (CDI) on MRI. Bivariate and linear regression analysis was performed to detect the association of anthropometric data with anatomic parameters measured on MRI studies. RESULTS: The mean age and body mass index were not significantly different between the male and female patients; however, male patients were significantly taller than female patients (1.75 vs 1.72 m, respectively; P < .001). There was a substantial agreement between the 3 readers for all parameters (κ > 0.75). Overall, female patients had significantly longer PTL (47.38 vs 43.92 mm), higher CDI (1.146 vs 1.071), and shorter IAL (33.05 vs 34.39 mm) (P < .001 for all). Results of the linear regression analysis demonstrated that both height and female sex were predictive of longer PTL. Further, height was independently predictive of IAL but sex was not. CONCLUSION: PTL was correlated more with patient sex than height. IAL was also correlated with patient sex. Longer BTB grafts are expected to be harvested in female patients compared with male patients of the same height despite shorter IAL. These associations should be considered during BTB ACL reconstruction to minimize graft-tunnel mismatch. SAGE Publications 2021-05-03 /pmc/articles/PMC8114262/ /pubmed/34017879 http://dx.doi.org/10.1177/23259671211003244 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Campbell, Abigail L.
Caldwell, Jon-Michael E.
Yalamanchili, Dheeraj
Sepanek, Lia
Youssefzadeh, Keon
Uquillas, Carlos A.
Limpisvasti, Orr
Effect of Patient Height and Sex on the Patellar Tendon and Anterior Cruciate Ligament
title Effect of Patient Height and Sex on the Patellar Tendon and Anterior Cruciate Ligament
title_full Effect of Patient Height and Sex on the Patellar Tendon and Anterior Cruciate Ligament
title_fullStr Effect of Patient Height and Sex on the Patellar Tendon and Anterior Cruciate Ligament
title_full_unstemmed Effect of Patient Height and Sex on the Patellar Tendon and Anterior Cruciate Ligament
title_short Effect of Patient Height and Sex on the Patellar Tendon and Anterior Cruciate Ligament
title_sort effect of patient height and sex on the patellar tendon and anterior cruciate ligament
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8114262/
https://www.ncbi.nlm.nih.gov/pubmed/34017879
http://dx.doi.org/10.1177/23259671211003244
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