Avoiding mismatch in allograft anterior cruciate ligament reconstruction: correlation between patient height and patellar tendon length.

PURPOSE: The purpose of this study was to evaluate whether a correlation exists between patient height and soft-tissue patellar tendon length. METHODS: Magnetic resonance imaging (1.5 T) was performed for knee pathology on 403 patients. The patellar tendon length was measured in the midsagittal plane by a board-certified musculoskeletal radiologist. Patient height was recorded to the nearest inch. Patients were grouped into 6 subgroups with 4-inch range intervals based on height. The entire study group was analyzed. Subgroup analysis and gender analysis were performed to determine statistical significance. RESULTS: The mean patellar tendon length was 45 +/- 7 mm (range, 30 to 66 mm). Wide ranges were noted among each height subgroup irrespective of gender. Significant differences were noted between most height subgroups independent of gender. CONCLUSIONS: This study showed that a correlation exists between patient height, gender, and patellar tendon length. Although variation occurs among patients of the same height, significant differences in mean patellar tendon lengths do exist between patients in different height subgroups. CLINICAL RELEVANCE: Parameters are provided using patient gender and height to reduce the potential for graft-construct mismatch when ordering bone-patellar tendon-bone allografts for anterior cruciate ligament reconstruction.

Abnormal findings on knee magnetic resonance imaging in asymptomatic NBA players.

The purpose of this study was to evaluate the knees of asymptomatic National Basketball Association (NBA) players via magnetic resonance imaging (MRI) and confirm or dispute findings reported in the previous literature. It is thought that a variety of significant abnormalities affecting the knee exist in asymptomatic patients and that these findings can be accurately identified on MRI. Two months prior to the 2005 season, bilateral knee MRI examinations of 14 asymptomatic NBA players (28 knees) were evaluated for abnormalities of the articular cartilage, menisci, and patellar and quadriceps tendons. The presence of joint effusion, subchondral edema, and cystic lesions and the integrity of the collateral and cruciate ligaments were also assessed.

Clinical and magnetic resonance imaging outcomes after surgical repair of complete proximal hamstring ruptures: does the tendon heal?

BACKGROUND: The use of validated outcome questionnaires and magnetic resonance imaging (MRI) when assessing outcomes after surgical treatment of proximal hamstring avulsions has been limited. PURPOSE: To comprehensively evaluate clinical, functional, and radiological outcomes in patients treated with surgical repair for complete proximal hamstring avulsions. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A retrospective review of 15 consecutive patients was performed. Outcome measures included the Single Assessment Numeric Evaluation (SANE), visual analog scale (VAS) for pain, Proximal Hamstring Injury Questionnaire, Lower Extremity Functional Scale (LEFS), Harris Hip Score (HHS), and Tegner Activity Scale (TAS). Physical examination was performed by an independent sports medicine fellow. Magnetic resonance imaging of the lower extremity was used to assess tendon healing and muscle quality after repair. RESULTS: Thirteen of 15 (87%) eligible patients were available for follow-up at a mean 36.9 months (range, 27-63 months), including 8 men and 6 left-sided injuries. The average age was 44.6 years (range, 26-58 years). Twelve of 13 patients underwent surgical repair within 60 days of injury. Mean (± standard deviation) postoperative functional outcome scores were as follows: LEFS, 74.9 ± 7.8 (range, 59-80); HHS, 90.7 ± 13.9 (range, 67-100); SANE, 93.6 ± 7.5 (range, 75-100); VAS for pain, 1.3 ± 1.9 (range, 0-5); and TAS, 4.6 ± 2.3 (range, 1-7). All 11 patients who participated in sports before surgery were able to return to sport, but 45% reported a decrease in their current level of activity. Isokinetic muscle testing demonstrated that injured hamstring strength recovered up to 78% ± 6.1% (range, 74%-88%) of the contralateral side. The MRI examinations revealed that 100% of patients had a healed proximal hamstring repair, with signs of tendinopathy and mild atrophy in 3 of 12 patients. CONCLUSION: The current findings indicate that surgical repair of complete hamstring ruptures provides reliable pain relief, good functional outcomes, high satisfaction rates, and excellent healing rates (MRI) but does not fully restore hamstring function and sports activity to preinjury levels.