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

<h3>Purpose</h3><p dir="ltr">This systematic review and meta-analysis aimed to investigate the correlation between anthropometric measurements and graft size in anterior cruciate ligament (ACL) reconstruction.</p><h3>Methods</h3><p dir="ltr">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.</p><h3>Results</h3><p dir="ltr">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).</p><h3>Conclusion</h3><p dir="ltr">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.</p><h3>Level of evidence</h3><p dir="ltr">Level of Evidence: IV.</p><p dir="ltr">PROSPERO registration number: CRD42023416044.</p><h2>Other Information</h2><p dir="ltr">Published in: European Journal of Orthopaedic Surgery & Traumatology<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00590-023-03712-w" target="_blank">https://dx.doi.org/10.1007/s00590-023-03712-w</a></p>