Prediction of the quadruple hamstring autograft thickness in ACL reconstruction using anthropometric measures.

OBJECTIVE: The aim of this study was to determine whether simple anthropometric measurements, such as height, weight, body mass index (BMI), age, and thigh circumference can be used to accurately predict the diameter of hamstring tendons for anterior cruciate ligament (ACL) reconstruction surgery. METHODS: One hundred sixty-four consecutive male patients who underwent ACL reconstruction using quadruple hamstring autograft between January 2010 and December 2011 were prospectively evaluated. Anthropometric measurements including height, weight, BMI, age and thigh circumference were recorded preoperatively. The thickness of the quadruple hamstring autograft was intraoperatively determined using sizing cylinders. Correlation coefficients (Pearson's r) and stepwise, multiple linear regression were used to determine the relationship between the outcome variable (hamstring graft diameter) and the predictor variables (age, height, weight, BMI, thigh circumference). RESULTS: Correlation analysis revealed a positive relation between the height, weight and graft thickness (p=0.000 and p=0.002, respectively). Taller and heavier patients tended to have thicker quadrupled hamstring graft. However, age, thigh circumference, and BMI did not correlate with the graft thickness (p=0.700, p=0.290 and p=0.727, respectively). Stepwise, multiple linear regression indicated that height was statistically important as a predictor for hamstring graft diameter (R2=0.157, p=0.0001) and yielded the following regression equation for predicting quadrupled hamstring graft thickness: graft thickness = [(height in cm) x 0.052) - 1.07] mm. CONCLUSION: Height can be used as a practical and accurate measurement to preoperatively predict quadruple hamstring graft diameter in male patients. Identification of possible hamstring tendon autograft insufficiency allows for preoperative determination of additional graft source possibilities, resulting in a more prompt surgical strategy.

Comparison of bony healing and cartilage degeneration following strut grafting and trapdoor procedures in an ovine model.

This experimental study compared bony healing and cartilage degeneration following strut grafting and trapdoor procedures for osteonecrosis of the femoral head in an ovine model. Osteonecrosis and a bony defect were created surgically in 16 hips of 8 Merino sheep, and the index grafting procedures were performed in a second session. Three months after surgery, the hips treated by strut grafting yielded better articular cartilage protection and bony healing compared to the osteonecrosis groups. The trapdoor group yielded better bony healing compared to the rest of the groups, but the grafts and the osteochondral flaps failed to unite with the host bone. These findings indicate elevating the osteochondral flap during the trapdoor procedure injures the cartilage and may cause degeneration.

Nerve entrapment in painful heel syndrome.

Subcalcaneal heel pain is one of the most common foot ailments, yet the exact etiology is still controversial. Nerve entrapment has been suggested as one of the possible causes of this painful condition in recalcitrant cases. The purpose of this study is to determine the role of nerve entrapment in painful heels. Twenty patients with heel pain (25 heels) were compared with an age and body mass index-matched control population using electrodiagnostic methods. The results of the study revealed 22 heels (88%) with heel pain had lateral plantar nerve entrapment signs with or without medial plantar nerve findings on EMG. There were no abnormal values in the control group. Nerve entrapment syndrome has previously been considered only in cases with intractable heel pain, but this study suggests that it may play a role the early phases of painful heel syndrome.