Effect of meniscus repair on pivot-shift during anterior cruciate ligament reconstruction: Objective evaluation using triaxial accelerometer

Katakura, Mai; Horie, Masafumi; Watanabe, Toshifumi; Katagiri, Hiroki; Otabe, Koji; Ohara, Toshiyuki; Nakamura, Kaori; Katagiri, Kenta; Ueki, Hiroko; Zaffagnini, Stefano; Sekiya, Ichiro; Muneta, Takeshi; Koga, Hideyuki

doi:10.1016/j.knee.2018.11.016

Cited by 39 publications

(46 citation statements)

References 27 publications

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“…Numerous cadaveric and clinical studies have suggested that meniscal deficiency has an important influence on the pivot shift. 7,10,12,19,28 However, consistent with the findings of the current study, Hoshino et al, 7 in a small clinical study (n = 57), did not find a difference in the clinical grade of pivot shift in knees with and without meniscal tears. However, they did demonstrate that when a quantitative pivot shift was assessed with an electromagnetic measurement system, there was increased tibial acceleration in knees with lateral but not medial meniscal tears.…”

Section: Discussionsupporting

confidence: 89%

“…However, they did demonstrate that when a quantitative pivot shift was assessed with an electromagnetic measurement system, there was increased tibial acceleration in knees with lateral but not medial meniscal tears. In addition, Katakura et al 10 recently demonstrated that repair of lateral but not medial meniscal tears before ACL reconstruction significantly reduced tibial acceleration during the pivot-shift test, but they did not report the IKDC grade. These studies both suggest that meniscal tears do have an influence on components of the pivot shift, but the actual changes in tibial acceleration are small.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Grade 3 Pivot Shift in Knees With Acute Anterior Cruciate Ligament Injuries: A Comprehensive Evaluation of the Importance of Osseous and Soft Tissue Parameters From the SANTI Study Group

et al. 2020

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Background: Preoperative grade 3 pivot shift has been reported to be associated with higher rates of anterior cruciate ligament (ACL) failure, persistent instability, and inferior patient-reported outcomes. The etiology of a high-grade pivot shift is multifactorial, and numerous factors have been suggested to be responsible. More attention has recently been focused on injury to the anterolateral structures (ALS) as a risk factor for a grade 3 pivot shift. Purpose: To determine risk factors for grade 3 pivot shift, including soft tissue and osseous parameters. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A prospective evaluation was undertaken of 200 consecutive patients undergoing acute ACL reconstruction (within 10 days of injury). An open exploration of the lateral side of the injured knee was performed at the time of the index procedure. Details regarding patient and injury characteristics were recorded, as were details of soft tissue injuries, including meniscal tears, ALS lesions, medial collateral ligament tears, and chondral injuries. Osseous parameters (tibial slope and condylar ratios) were determined per established magnetic resonance imaging protocols. A multivariate logistic regression with penalized maximum likelihood was used to identify risk factors associated with International Knee Documentation Committee (IKDC) grade 3 pivot shift. Results: The mean ± SD age of the population was 28.3 ± 9.8 years; 67.5% of patients were male. Among patients, 35 (17.5%) had a high-grade pivot shift (IKDC grade 3), and 165 (82.5%) had a low-grade pivot shift (IKDC grades 1 and 2). Univariate and multivariate logistic regression analysis demonstrated that injury to the ALS was the only significant risk factor for grade 3 pivot shift (odds ratio, 13.49; 95% CI, 1.80-1725.53). Conclusion: This comprehensive evaluation of soft tissue and osseous factors has identified that injury to the ALS is the most important risk factor for grade 3 pivot shift in acute ACL-injured knees.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Risk Factors for Grade 3 Pivot Shift in Knees With Acute Anterior Cruciate Ligament Injuries: A Comprehensive Evaluation of the Importance of Osseous and Soft Tissue Parameters From the SANTI Study Group

et al. 2020

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“…The amount of displacement is important, as previous studies have shown that it correlates with the continuum of ACL injuries, ranging from partial to complete tears of the single ligament, as well as with associated soft tissue injuries, including meniscal tears. 5,8,12,13,17 Another important factor in considering ACL injury risk and prognosis is the magnitude of posterior tibial slope. 1,14,16,24 Importantly, preoperative identification of these factors could enhance surgical planning and limit future retears and complications.…”

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confidence: 99%

Coronal Lateral Collateral Ligament Sign: A Novel Magnetic Resonance Imaging Sign for Identifying Anterior Cruciate Ligament–Deficient Knees in Adolescents and Summarizing the Extent of Anterior Tibial Translation and Femorotibial Internal Rotation

et al. 2021

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Background: Incompetence of the anterior cruciate ligament (ACL) confers knee laxity in the sagittal and axial planes that is measurable with clinical examination and diagnostic imaging. Hypothesis: An ACL-deficient knee will produce a more vertical orientation of the lateral collateral ligament (LCL), allowing for the entire length of the LCL to be visualized on a single coronal slice (coronal LCL sign) on magnetic resonance imaging. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Charts were retrospectively reviewed from April 2009 to December 2017 for all patients treated with ACL reconstruction (constituting the ACL-deficient cohort). A control cohort was separately identified consisting of patients with a normal ACL and no pathology involving the collateral ligaments or posterior cruciate ligament. Patients were excluded for follow-up <2 years, incomplete imaging, and age >19 years. Tibial translation and femorotibial rotation were measured on magnetic resonance images, and posterior tibial slope was measured on a lateral radiograph of the knee. Imaging was reviewed for the presence of the coronal LCL sign. Results: The 153 patients included in the ACL-deficient cohort had significantly greater displacement than the 70 control patients regarding anterior translation (5.8 vs 0.3 mm, respectively; P < .001) and internal rotation (5.2° vs −2.4°, P < .001). Posterior tibial slope was not significantly different. The coronal LCL sign was present in a greater percentage of ACL-deficient knees than intact ACL controls (68.6% vs 18.6%, P < .001). The presence of the coronal LCL sign was associated with greater anterior tibial translation (7.2 vs 0.2 mm, P < .001) and internal tibial rotation (7.5° vs –2.4°, P = .074) but not posterior tibial slope (7.9° vs 7.9°, P = .973) as compared with its absence. Multivariate analysis revealed that the coronal LCL sign was significantly associated with an ACL tear (odds ratio, 12.8; P < .001). Conclusion: Our study provides further evidence that there is significantly more anterior translation and internal rotation of the tibia in the ACL-deficient knee and proves our hypothesis that the coronal LCL sign correlates with the presence of an ACL tear. This coronal LCL sign may be of utility for identifying ACL tears and anticipating the extent of axial and sagittal deformity.

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“…Second, the pivot shift test was performed manually by four different surgeons. However, the test was performed by experienced surgeons, and the pivot shift test technique was standardized before starting the present research to minimize the variation of the pivot shift technique and a good inter-rater reliability of the acceleration data during pivot shift test measured by the same triaxial accelerometer has been reported to be 0.97 for ACL-injured knees and 0.99 for ACL-uninjured knees [27]. A further limitation was that this study only determined the kinematics of the knee at the time of surgery.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for residual anterolateral rotational instability after double bundle anterior cruciate ligament reconstruction: Evaluation by quantitative assessment of the pivot shift phenomenon using triaxial accelerometer

et al. 2020

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Effect of meniscus repair on pivot-shift during anterior cruciate ligament reconstruction: Objective evaluation using triaxial accelerometer

Cited by 39 publications

References 27 publications

Risk Factors for Grade 3 Pivot Shift in Knees With Acute Anterior Cruciate Ligament Injuries: A Comprehensive Evaluation of the Importance of Osseous and Soft Tissue Parameters From the SANTI Study Group

Risk Factors for Grade 3 Pivot Shift in Knees With Acute Anterior Cruciate Ligament Injuries: A Comprehensive Evaluation of the Importance of Osseous and Soft Tissue Parameters From the SANTI Study Group

Coronal Lateral Collateral Ligament Sign: A Novel Magnetic Resonance Imaging Sign for Identifying Anterior Cruciate Ligament–Deficient Knees in Adolescents and Summarizing the Extent of Anterior Tibial Translation and Femorotibial Internal Rotation

Risk factors for residual anterolateral rotational instability after double bundle anterior cruciate ligament reconstruction: Evaluation by quantitative assessment of the pivot shift phenomenon using triaxial accelerometer

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