Prediction of Quadrupled Hamstring Graft Thickness for Anterior Cruciate Ligament Reconstruction Using Anthropometric Measurements: A Prospective Study.

BACKGROUND: Anterior cruciate ligament (ACL) reconstruction using hamstring autograft is a standard procedure for restoring knee stability. Graft diameter is a key determinant of surgical success, with smaller grafts associated with higher failure rates. Preoperative prediction of hamstring graft size using simple anthropometric parameters may assist in surgical planning and improve outcomes. OBJECTIVES: To evaluate the relationship between anthropometric measurements and quadrupled hamstring graft diameter in patients undergoing ACL reconstruction. METHODS: This prospective study was conducted at a tertiary care center over 18 months (August 2023-February 2025) and included 48 patients aged 18-55 years undergoing primary ACL reconstruction with hamstring autograft. Preoperative parameters recorded included age, gender, height, weight, body mass index (BMI), and thigh circumference. Graft diameter was measured intraoperatively using a graft sizing block. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York), with p < 0.05 considered significant. RESULTS: The mean age was 40.5 ± 8.3 years, with male predominance (70.8%). Mean height, weight, and BMI were 165.7 ± 6.6 cm, 78.8 ± 7.9 kg, and 24.9 ± 3.9 kg/m², respectively. The mean thigh circumference and graft diameter were 53.0 ± 5.0 cm and 7.91 ± 0.82 mm. Height showed a strong positive correlation with graft diameter (r = 0.666, p < 0.001), while thigh circumference showed a moderate positive correlation (r = 0.367, p = 0.010). BMI demonstrated a significant negative correlation (r = -0.330, p = 0.022). Males had significantly larger graft diameters than females (8.30 ± 0.60 mm vs 6.96 ± 0.41 mm, p < 0.001). CONCLUSION: Anthropometric parameters, particularly height, are reliable predictors of hamstring graft diameter in ACL reconstruction. Preoperative assessment can help identify patients at risk of inadequate graft size and guide surgical planning, including consideration of alternative graft options to optimize outcomes.