Preoperative prediction of four stranded hamstring graft size in anterior cruciate ligament Reconstruction: Is magnetic resonance imaging evaluation of semitendinosus and gracillis tendon better than anthropometric data?

Bishnu Prasad; Sudhanshu Sekhar Das; Sudarsan Behera; Saroj Kumar Patra; Paulson Verghese; Ashish Kumar Satapathy

doi:10.1016/j.jcot.2025.103057

Preoperative prediction of four stranded hamstring graft size in anterior cruciate ligament Reconstruction: Is magnetic resonance imaging evaluation of semitendinosus and gracillis tendon better than anthropometric data?

J Clin Orthop Trauma. 2025 May 13:67:103057. doi: 10.1016/j.jcot.2025.103057. eCollection 2025 Aug.

Authors

Bishnu Prasad¹, Sudhanshu Sekhar Das², Sudarsan Behera³, Saroj Kumar Patra⁴, Paulson Verghese¹, Ashish Kumar Satapathy⁵

Affiliations

¹ Department of Orthopaedics, AIIMS Bhubaneswar, Odisha, 751019, India.
² Regional Spinal Injury Centre, SCB Medical College, Cuttack, Odisha, 753007, India.
³ Department of Trauma & Emergency Orthopaedics, AIIMS Raipur, Chhatisgarh, 492099, India.
⁴ Department of Trauma and Emergency, AIIMS Bhubaneswar, Odisha, 751019, India.
⁵ Department of Radiology, IMS and SUM Hospital, Odisha, 751003, India.

PMID: 40496039
PMCID: PMC12145989 (available on 2026-05-13)
DOI: 10.1016/j.jcot.2025.103057

Abstract

Background: To determine the correlation between intraoperative measurements of four-stranded hamstring grafts, preoperative MRI measurements, and anthropometric measurements. The study aimed to provide insights into graft diameter assessment and assist in the selection of hamstrings for graft preparation in the Indian population.

Material and methods: In this prospective study, 50 patients with complete anterior cruciate ligament (ACL) injuries, with or without meniscal injuries, were included. Prior to surgery, anthropometric data and the largest axial diameter of the semitendinous and gracilis tendon at the medial femoral epicondyle were measured. The study aimed to establish correlations between Final diameter of the graft, preoperative hamstring graft diameter and anthropometric measurements.

Results: Radiological data was found to predict graft diameter better than anthropometric data. Gracilis diameter was more specific for graft diameters ≥8 mm.

Conclusion: Preoperative hamstring tendon diameter in the MRI is better predictor as compared to anthropometric data to predict of four strandend size of the graft.

Keywords: Anterior cruciate ligament; Hamstring tendons; Knee injuries; Magnetic resonance imaging; Tendon graft.