Optimal measurement of clinical rotational test for evaluating anterior cruciate ligament insufficiency

Abstract

The rotational instability of the ACL deficiency was reproduced only by the pivot shift test and detected only by measuring the tibial anteroposterior translation and acceleration of the tibial posterior reduction. Level of evidence Diagnostic study, Level III.

Comparison of three non-invasive quantitative measurement systems for the pivot shift test

“…The knee kinematics coordinate system defined by Grood and Suntay [16] was digitally configured after digitizing the three-dimensional (3-D) position of the anatomical landmarks using another sensor as previously described [16,17]. From the knee kinematics data, the anterior tibial translation and tibial acceleration for the pivot shift test could be calculated [3,7,[18][19][20][21][22]]. This electromagnetic system had a root mean square accuracy of 0.76 mm for position and 0.158 for orientation [23].…”

“…The electromagnetic sensors were applied to the skin on the thigh and calf by means of a plastic brace fixed by circumferential Velcro Ò straps 10 cm above the superior pole of the patella and 7 cm below the tibial tubercle, respectively. The results were calculated as described in previous studies [3,7,[18][19][20][21][22]. 2.…”

Electromagnetic tracking of the pivot-shift

“…Although some might pay more attention to the axial rotational angle change than the anteroposterior translation of the tibia due to the name of the rotational laxity, abnormality of the axial rotation was hard to be detected during the pivot shift test in the ACL-deficient knee because of its inconsistency [18,31,33,37]. The rotational laxity is sometimes misunderstood as rotational angle change against a simple axial rotational stress, but a simple axial rotational stress test is unable to demonstrate abnormal knee kinematics in the ACLdeficient knees [38].…”

Partial Anterior Cruciate Ligament Ruptures: Knee Laxity Measurements and Pivot Shift

“…Hoshino et al highlighted that acceleration during the reduction phase of the pivot shift is a good indicator of rotational instability, which reflects the dynamic behavior of the pivot-shift phenomenon (Hoshino et al 2012c). …”