Correlation between anthropometric measurements and graft size in anterior cruciate ligament reconstruction: a systematic review and meta-analysis.

ABSTRACT

PURPOSE: This systematic review and meta-analysis aimed to investigate the correlation between anthropometric measurements and graft size in anterior cruciate ligament (ACL) reconstruction. METHODS: A systematic search of Ovid MEDLINE, Embase, and Cochrane Library databases was conducted for observational studies published until March 2023 that reported the relationship between anthropometric data [height, weight, body mass index (BMI), age, gender, thigh length, and circumference] and ACL graft size. Correlation coefficients (COR) and their associated 95% confidence intervals were used as the primary effect size. This review was conducted in line with PRISMA guidelines. RESULTS: A total of 42 observational studies involving 7110 patients were included, with a mean age of 29.8 years. Statistically significant, moderately positive correlations were found between graft size and height (COR 0.49; 95% CI 0.41-0.57; p-value < 0.001), weight (COR 0.38; 95% CI 0.31-0.44; p-value < 0.001), thigh circumference (COR 0.40; 95% CI 0.19-0.58; p-value < 0.001), and thigh length (COR 0.35; 95% CI 0.18-0.50; p-value < 0.001). However, age and gender were insignificantly correlated with graft size (p-value NS). A subanalysis based on graft type showed a significant positive correlation between height and graft diameter, which was more significant in the peroneus tendon than in hamstring grafts (COR 0.76 vs. 0.45; p-value 0.020). CONCLUSION: This study demonstrated a moderate positive correlation between anthropometric measurements (height, weight, thigh circumference, and length) and ACL graft size, along with a weak positive correlation with BMI. Age and gender showed no significant correlation. These findings support the predictability and selection of ACL graft size based on pre-operative patient anthropometric data. LEVEL OF EVIDENCE Level of Evidence IV. PROSPERO registration number CRD42023416044.