Predicting anterior cruciate ligament integrity in patients with osteoarthritis

Trompeter, Alex; Gill, Karminder S.; Appleton, M. A. C.; Palmer, Sylvain

doi:10.1007/s00167-008-0701-0

Cited by 21 publications

(13 citation statements)

References 16 publications

(26 reference statements)

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“…Thus, knowledge of ACL integrity prior to use of these implants is paramount, as partial ruptures and fissuring have been shown to significantly affect the histological and functional characteristics of the ACL. 27 An accurate assessment of the integrity of the ACL prior to operating will help to guide the surgeon to the possible options of joint replacement in each case, as well as manage the patients' expectations and the consent process. As we replace the knee in the younger and younger individual, we are striving to maintain, as close to normal, the biomechanics and function of the knee joint, for which an intact and functioning ACL is necessary.…”

Section: Discussionmentioning

confidence: 99%

The Pivot Shift Test Is of Limited Clinical Relevance in the Arthritic Anterior Cruciate Ligament-Deficient Knee

Dodd¹,

Trompeter²,

Harrison³

et al. 2010

J Knee Surg

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The pivot shift test is used to assess the integrity of the anterior cruciate ligament (ACL).This test has been shown to be highly sensitive in detecting instability in knees with complete ACL rupture. However, in the presence of osteoarthritis, the rotation and subluxation required for the pivot shift to be effective can be limited and therefore is likely to impact upon the reliability of this test. We performed the pivot shift test on 50 patients, under general anesthesia, prior to total knee replacement and then recorded the integrity of the ACL intraoperatively. This allowed us to assess the accuracy of this test in the presence of significant osteoarthritis. Of the 50 knees tested, none had a positive pivot shift test preoperatively; however, 14% of the knees included in the study had a completely ruptured ACL. This gives a sensitivity of 0% and a specificity of 1% for the pivot shift test for ACL ruptures in the presence of established osteoarthritis. We conclude that the pivot shift test may not be a reliable test for ACL function in the presence of symptomatic arthritis of the knee.

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Section: Discussionmentioning

confidence: 99%

The Pivot Shift Test Is of Limited Clinical Relevance in the Arthritic Anterior Cruciate Ligament-Deficient Knee

Dodd¹,

Trompeter²,

Harrison³

et al. 2010

J Knee Surg

View full text Add to dashboard Cite

show abstract

“…Although the underlying mechanisms of CCL pathology are undefined, predisposed dogs have thinner collagen fibrils in weaker CCLs that have increased expression of matrix metalloproteinase 2 than those of cruciate disease-resistant breeds such as Greyhounds 82 . Importantly, although ACL rupture in young humans is generally considered to be traumatic in cause, ~70% of macroscopically normal human ACLs also have histological evidence of pathology consistent with early degeneration 89 . Genetics.…”

Section: Knee Cruciate Ligament Rupturementioning

confidence: 99%

Spontaneous dog osteoarthritis — a One Medicine vision

et al. 2019

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| Osteoarthritis (OA) is a global disease that, despite extensive research, has limited treatment options. Pet dogs share both an environment and lifestyle attributes with their owners, and a growing awareness is developing in the public and among researchers that One Medicine, the mutual co-study of animals and humans, could be beneficial for both humans and dogs. To that end, this Review highlights research opportunities afforded by studying dogs with spontaneous OA , with a view to sharing this active area of veterinary research with new audiences. Similarities and differences between dog and human OA are examined, and the proposition is made that suitably aligned studies of spontaneous OA in dogs and humans, in particular hip and knee OA , could highlight new avenues of discovery. Developing cross-species collaborations will provide a wealth of research material and knowledge that is relevant to human OA and that cannot currently be obtained from rodent models or experimentally induced dog models of OA. Ultimately , this Review aims to raise awareness of spontaneous dog OA and to stimulate discussion regarding its exploration under the One Medicine initiative to improve the health and well-being of both species.

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“…This could be partly explained by work by Trompeter et al who showed that patients with macroscopically normal ACLs in arthritic knees actually showed significant signs of histological degeneration. 36 Citak et al demonstrated that with respect to the Lachman and the pivot shift tests, single-bundle ACL reconstruction restored kinematics in the UKA knee to magnitudes similar to those in the ACL-intact knee. 37 An in vivo kinematic study by Pandit et al demonstrated that normal knee kinematics is achieved in the ACL-deficient arthritic knee, following ACL reconstruction and UKA.…”

Section: Is Anterior Cruciate Ligament Deficiency a Contraindication mentioning

confidence: 99%

Unicompartmental Knee Arthroplasty: The Past, Current Controversies, and Future Perspectives

et al. 2018

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Unicompartmental knee arthroplasty (UKA) is a bone conserving and ligament-sparing procedure that reliably restores normal knee kinematics and function for arthritis limited either to the medial or the lateral compartment of the knee. Although there is enough evidence to demonstrate that the UKA offers good medium to long-term success given the correct patient selection, prosthesis design, and implantation technique, there are several reports to suggest inferior survival rates in comparison with the total knee arthroplasty (TKA). Furthermore, it is a specialized procedure which works well in the hands of the experienced operator and therefore different authors' tend to draw different conclusions based on the same evidence, and as a result, there is great variability in the usage of the UKA. The aim of this current concept's review is to present to the readers the history of the UKA especially with reference to implant design, discuss current controversies, and outline the future perspectives of this novel procedure.

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Predicting anterior cruciate ligament integrity in patients with osteoarthritis

Cited by 21 publications

References 16 publications

The Pivot Shift Test Is of Limited Clinical Relevance in the Arthritic Anterior Cruciate Ligament-Deficient Knee

The Pivot Shift Test Is of Limited Clinical Relevance in the Arthritic Anterior Cruciate Ligament-Deficient Knee

Spontaneous dog osteoarthritis — a One Medicine vision

Unicompartmental Knee Arthroplasty: The Past, Current Controversies, and Future Perspectives

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