Harald K Widhalm1,2, Levent Surer3, Nikhil Kurapati3, Claudia Guglielmino3, James J Irrgang3, Freddie H Fu3. 1. Department of Orthopaedic Surgery, University of Pittsburgh, Kaufman Building Suite 1011, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA. hwidhalm@me.com. 2. Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria. hwidhalm@me.com. 3. Department of Orthopaedic Surgery, University of Pittsburgh, Kaufman Building Suite 1011, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA.
Abstract
PURPOSE: This study was undertaken primarily to identify the tibial insertion site length of ruptured ACL fibres in patients undergoing primary ACL reconstruction. A secondary aim was to evaluate the correlation of pre- and intra-operative measurements. METHODS: In 146 patients undergoing primary ACL reconstruction, a preoperative measurement on MRI of the tibial ACL insertion site length was taken by two raters and then compared with single surgeon's intra-operative measurements using a specialized ruler. Inclusion criteria were primary ACL reconstruction and MRI performed within 3 months prior to surgery on one specific MRI machine at the study centre. Inter-rater and intra-rater reliability based on intra class correlation (ICC) was calculated. Additionally, correlation between preoperative and postoperative measurements and the anthropometric data was assessed using Pearson correlation. RESULTS: The tibial ACL insertion site had a mean length of 16.6 ± 1.6 mm (11.9-21.0) as measured by MRI, and 16.4 ± 1.6 mm (11.0-20.0) as measured intra-operatively. The ICCs for intra- and inter-rater reliability of the MRI measurements were 0.99 (95 % CI 0.97; 0.99; p < 0.001) and 0.81 (95 % CI 0.75; 0.86; p < 0.001), respectively. Regression analysis demonstrated, after controlling for subject height and weight, that the MRI measurements significantly predicted intra-operative measurement of tibial insertion site length (β = 0.796; R (2)-change 0.77; p < 0.001). CONCLUSION: Preoperative measurement of the tibial ACL length is possible using MRI and can be a valuable aid in more efficient preoperative planning given the knowledge of expected dimensions of special knee structures. LEVEL OF EVIDENCE: III.
PURPOSE: This study was undertaken primarily to identify the tibial insertion site length of ruptured ACL fibres in patients undergoing primary ACL reconstruction. A secondary aim was to evaluate the correlation of pre- and intra-operative measurements. METHODS: In 146 patients undergoing primary ACL reconstruction, a preoperative measurement on MRI of the tibial ACL insertion site length was taken by two raters and then compared with single surgeon's intra-operative measurements using a specialized ruler. Inclusion criteria were primary ACL reconstruction and MRI performed within 3 months prior to surgery on one specific MRI machine at the study centre. Inter-rater and intra-rater reliability based on intra class correlation (ICC) was calculated. Additionally, correlation between preoperative and postoperative measurements and the anthropometric data was assessed using Pearson correlation. RESULTS: The tibial ACL insertion site had a mean length of 16.6 ± 1.6 mm (11.9-21.0) as measured by MRI, and 16.4 ± 1.6 mm (11.0-20.0) as measured intra-operatively. The ICCs for intra- and inter-rater reliability of the MRI measurements were 0.99 (95 % CI 0.97; 0.99; p < 0.001) and 0.81 (95 % CI 0.75; 0.86; p < 0.001), respectively. Regression analysis demonstrated, after controlling for subject height and weight, that the MRI measurements significantly predicted intra-operative measurement of tibial insertion site length (β = 0.796; R (2)-change 0.77; p < 0.001). CONCLUSION: Preoperative measurement of the tibial ACL length is possible using MRI and can be a valuable aid in more efficient preoperative planning given the knowledge of expected dimensions of special knee structures. LEVEL OF EVIDENCE: III.
Authors: Stephen J Rabuck; Kellie K Middleton; Shugo Maeda; Yoshimasa Fujimaki; Bart Muller; Paulo H Araujo; Freddie H Fu Journal: Arthrosc Tech Date: 2012-03-03
Authors: Marty E Reed; Diego C Villacis; George F Rick Hatch; Wendy S Burke; Patrick M Colletti; Steven J Narvy; Raffy Mirzayan; C Thomas Vangsness Journal: Orthopedics Date: 2013-08 Impact factor: 1.390
Authors: Daniel Guenther; Sebastian Irarrázaval; Marcio Albers; Cara Vernacchia; James J Irrgang; Volker Musahl; Freddie H Fu Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-08-19 Impact factor: 4.342