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.