Anterior Cruciate Ligament Sizing Tools Can Be Interchanged Without Affecting Graft Diameter Measurement

Abstract

Purpose: To determine whether different types of measurement tools can be interchanged without significantly affecting the resulting graft diameter. Methods: Hamstrings (gracilis and semitendinosus) and quadriceps tendons in 33 cadaver knees were harvested. Three different anterior cruciate ligament (ACL) graft combinations were created using these tendons, making 99 cadaver grafts samples available to measure. The grafts were randomly passed through sizing tubes and a slotted measurement block to determine their diameter. Interobserver and intraobserver reliabilities of measurements were assessed. Pearson correlation test, as well as Bland Altman graph, were used to evaluate the interchangeability of the tools. Results: In 95% of cases, the diameter difference between the tubes and the block measures was less than the 0.5 mm in increment cutoff. Both the intraobserver and interobserver reliability were excellent. Conclusions: This study showed that the ACL graft diameter measurement does not vary whether a slotted block or sizing tube from the same company is used. Clinical Relevance: ACL graft size has an influence on the surgical technique and clinical outcomes. Therefore it is important to have reliable sizing tools.