Size Comparison of the Cadaveric Anterior Cruciate Ligament Midsubstance Cross-Sectional Area and the Cross-Sectional Area of Semitendinosus Double-Bundle Anterior Cruciate Ligament Reconstruction Autografts in Surgery

Abstract

The purpose of this study was to compare the cadaveric midsubstance cross-sectional anterior cruciate ligament (ACL) area and the cross-sectional semitendinosus (ST) double-bundle ACL autograft area in surgery. Thirty-nine nonpaired formalin-fixed cadaveric knees and 39 subjects undergoing ST double-bundle ACL reconstruction were included in this study. After soft tissue resection, cadaveric knees were flexed at 90 degrees, and the tangential line of the femoral posterior condyles was marked and sliced on the ACL midsubstance. The cross-sectional ACL area was measured using Image J software. In the patients undergoing ACL surgery, the harvested ST was cut and divided into anteromedial (AM) bundle and posterolateral (PL) bundle. Each graft edge diameter was measured by a sizing tube, and the cross-sectional graft area was calculated: (AM diameter/2) 2× 3.14 + (PL diameter/2) 2× 3.14. Statistical analysis was performed for the comparison of the cross-sectional area between the cadaveric ACL midsubstance and the ST double-bundle ACL autografts. The cadaveric midsubstance cross-sectional ACL area was 49.0 ± 16.3 mm 2. The cross-sectional ST double-bundle autografts area was 52.8 ± 7.6 mm 2. The ST double-bundle autograft area showed no significant difference when compared with the midsubstance cross-sectional ACL area. ST double-bundle autografts were shown to be capable of reproducing the midsubstance cross-sectional ACL area.