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Maria Velasquez Hammerle, MD




Research Fellow




Women's Sports Medicine




Dr. Giovanna Ignacio Subira Medina*, Dr. Maria Velasquez Hammerle*, Dr. Miho J. Tanaka*

Sex-based difference of the most common tendon graft sources for ACL reconstruction measured on knee MRI

As a female Latin-American International Medical Graduate, I understand the importance of representation. Striving to succeed in a traditionally male-dominated specialty such as Orthopedic Surgery, having outstanding females as mentors and role models such as Dr. Tanaka has been inspiring, and has allowed my interest for Orthopedics to expand into Sports Medicine, specifically in patellofemoral disorders and using dynamic imaging tools to aid in its assessment. Participating in this symposium is important because it is a unique opportunity to celebrate female excellence in science and to inspire those coming after us, showing them that they too can achieve anything.

Background: Graft size in ACL reconstruction of less than 8mm has been associated with increased failure rates and complications. As women have smaller anatomy than men, the purpose of this study was to compare the sizes of structures most frequently harvested for autograft on MRI between males and females.

Methods: On knee MRI, using previously described techniques, patellar tendon, patella, quadriceps tendon and hamstring tendons were measured. Normative values were described and compared between males and females.

Results: Sixty patients (30 male, 30 female) were included. Measurements between women and men were significantly different, except for PT and QT thickness. In males, 97% and 93% had PT and QT widths >24mm to create a minimum 8mm graft, whereas this was true for only 70% and 66% of women (p=0.006, p=0.010).

Conclusion All autograft sources in women were found to be significantly smaller in length, width and diameter, but not thickness, and 30% of PT and 34% of QT did not have adequate width to create an 8mm graft.  Given associated risks with this, further studies are needed to identify optimal grafts to minimize morbidity in female patients.