Observational studyJournal of orthopaedic surgery and research2026
Preoperative MRI-based prediction of autograft diameter in ACL reconstruction using hamstring and peroneus longus tendons.
Observational study in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo evaluate the predictive value of magnetic resonance imaging (MRI)-derived cross-sectional area (CSA) measurements of hamstring and peroneus longus tendons in estimating intraoperative autograft diameter during anterior cruciate ligament (ACL) reconstruction, and to identify clinically useful CSA cut-offs for achieving graft diameters ≥ 8 mm.
methodsFifty-two patients undergoing primary ACL reconstruction were included in this prospective observational study, with 26 each in the hamstring tendon (HT) and peroneus longus tendon (PLT) autograft groups. Preoperative CSA was measured on axial MRI at specific anatomical levels. Intraoperative graft diameters were recorded post- harvest. Correlation analysis and receiver operating characteristic curves were used to assess predictive value and determine CSA thresholds for adequate graft size.
resultsFor the HT group, CSA measured at the medial femoral condyle showed the strongest correlation with intraoperative diameter (r = 0.782; p < 0.001), with an optimal CSA cut-off of ≥ 19.15 mm² (AUC 0.917, sensitivity: 85%, specificity: 100%). For the PLT group, ankle-level CSA best predicted graft diameter (cut-off: ≥12.84 mm², AUC 0.958, sensitivity: 95.8%, specificity: 100%).
conclusionMRI-based CSA measurement provides a reliable, non-invasive method for predicting autograft adequacy. This study establishes clinically relevant CSA thresholds for HT and PLT tendons and is the first to report such values for PLT, aiding preoperative graft selection in ACL reconstruction.
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