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

Katakura, Mai; Nakamura, Kaori; Watanabe, Toshifumi; Horie, Masafumi; Nakamura, Tomomasa; Katagiri, Hiroki; Otabe, Koji; Nakagawa, Yusuke; Ohara, Toshiyuki; Sekiya, Ichiro; Muneta, Takeshi; Koga, Hideyuki

doi:10.1016/j.knee.2019.09.016

Cited by 8 publications

(10 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The PS measurements by Bernholt, though, are subjective and do not use a quantitative analysis. Katakura et al used quantitative assessment of the PS acceleration and found no association with lateral meniscal injury; however, their assessment was performed after ACL reconstruction where the meniscus was addressed with repair or meniscectomy ( n = 45/46, n = 1/46, respectively [16]. Although providing excellent clinical relevance, the comparison of the data from Katakura et al to the present study is difficult given the timing of when PS assessment was performed.…”

Section: Discussionmentioning

confidence: 64%

Posterior tibial plateau impaction fractures are not associated with increased knee instability: a quantitative pivot shift analysis

Godshaw

Hughes

Lucidi

et al. 2023

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

PurposeThis study aimed to evaluate posterolateral tibial plateau impaction fractures and how they contribute to rotatory knee laxity using quantitative pivot shift analysis. It was hypothesised that neither the presence of nor the degree of involvement of the plateau would affect rotatory knee laxity in the ACL‐deficient knee. MethodsA retrospective review of prospectively collected data on 284 patients with complete anterior cruciate ligament (ACL) injuries was conducted. Posterolateral tibial plateau impaction fractures were identified on preoperative MRI. The patients were divided into two cohorts: “fractures” or “no fractures”. The cohort with fractures was further categorised based on fracture morphology: “extra‐articular”, “articular‐impaction”, or “displaced‐articular fragment”. All data were collected during examination under anaesthesia performed immediately prior to ACL reconstruction. This included a standard pivot shift test graded by the examiner and quantitative data including anterior tibial translation (mm) via Rolimeter, quantitative pivot shift (QPS) examination (mm) via PIVOT tablet technology, and acceleration (m/sec2) during the pivot shift test via accelerometer. Quantitative examinations were compared with the contralateral knee. ResultsThere were 112 patients with posterolateral tibial plateau impaction fractures (112/284, 39%). Of these, 71/112 (63%) were “extra‐articular”, 28/112 (25%) “articular‐impaction”, and 13/112 (12%) “displaced‐articular”. Regarding the two groups with or without fractures, there was no difference in subjective pivot shift (2 ± 0 vs 2 ± 0, respectively, n.s.), QPS (2.4 ± 1.6 mm vs 2.7 ± 2.2 mm, respectively, n.s.), anterior tibial translation measurements (6 ± 3 mm vs 5 ± 3 mm, respectively, n.s.), or acceleration of the knee during the pivot (1.7 ± 2.3 m/s2 vs 1.8 ± 3.1 m/s2, respectively, n.s.). When the fractures were further subdivided, subgroup analysis revealed no significant differences noted in any of the measured examinations between the fracture subtypes. ConclusionThis study showed that the posterolateral tibial plateau impaction fractures are commonly encountered in the setting of ACL tears; however, contrary to previous reports, they do not significantly increase rotatory knee laxity. This suggests that this type of concomitant injury may not need to be addressed at the time of ACL reconstruction. Level of evidenceLevel III.

show abstract

Section: Discussionmentioning

confidence: 64%

Posterior tibial plateau impaction fractures are not associated with increased knee instability: a quantitative pivot shift analysis

Godshaw

Hughes

Lucidi

et al. 2023

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…Several studies have found that DB-ACLR improved rotational stability more than did SB-ACLR, even if there was not a significant difference in clinical scores. 16,17,38 Maeyama et al 20 indicated that anatomic DB-ACLR better restored dynamic rotational laxity when compared with anatomic and nonanatomic SB-ACLR in a cadaveric study. Jarvela et al 14 stated that DB-ACLR resulted in significantly fewer graft failures than did SB-ACLR in a prospective randomized study with 10-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

Double-Bundle Versus Single-Bundle Anterior Cruciate Ligament Reconstruction in Patients With Significant Passive Anterior Tibial Subluxation

Lin

Wang

et al. 2022

Am J Sports Med

View full text Add to dashboard Cite

Background: Passive anterior tibial subluxation (PATS) is often observed in patients with anterior cruciate ligament tears. Postoperative outcomes of double-bundle (DB) and single-bundle (SB) anterior cruciate ligament reconstruction (ACLR) with significant PATS (>6 mm) are unclear. Hypothesis: DB-ACLR could achieve better stability and clinical outcomes than SB-ACLR in patients with PATS >6 mm. Study Design: Cohort study; Level of evidence, 3. Methods: Retrospective analysis was peformed on 626 consecutive patients who underwent primary anatomic ACLR between October 2016 and November 2017. Anterior subluxation of the lateral and medial compartments in extension relative to the femoral condyles was measured on preoperative magnetic resonance imaging scans. Among patients who demonstrated significant PATS (>6 mm) in the lateral compartment, 54 who underwent DB-ACLR (study group) were matched to 54 who underwent SB-ACLR (control group). PATS, stability (pivot-shift test and KT-2000 arthrometer), the Lysholm score, and the International Knee Documentation Committee (IKDC) grade were investigated preoperatively and at 3- to 4-year follow-up. Results: The preoperative mean PATS values in the lateral and medial compartments were not significantly different between groups (control vs study: lateral compartment, 8.1 ± 1.8 vs 8.5 ± 2.1 mm; medial compartment, 5.2 ± 1.9 vs 5.4 ± 1.9 mm; P > .05). Postoperatively, mean PATS values in the lateral and medial compartments of the study group were significantly improved as compared with the control group (control vs study: lateral compartment, 5.9 ± 2.8 vs 3.2 ± 4.1 mm; medial compartment, 3.7 ± 2.9 vs 1.4 ± 2.3 mm; P < .05). Significantly superior results were found for knee stability in the study group regarding the Lachman test (grade 0/1/2/3, study vs control: 29/22/3/0 vs 16/28/10/0; P = .031), pivot-shift test (grade 0/1/2/3, study vs control: 44/9/1/0 vs 30/19/5/0; P = .023), and KT-2000 arthrometer (study vs control: 2.5 ± 1.5 vs 3.9 ± 1.4 mm; P < .001). Clinical scores showed significantly better results in the study group in terms of IKDC score (study vs control: 87.9 ± 8.7 vs 81.2 ± 15.0; P = .01), Tegner activity score (study vs control: 6.0 ± 1.4 vs 4.9 ± 1.5; P < .001), and Lysholm score (study vs control: 91.7 ± 7.0 vs 86.3 ± 11.4; P = .004). Conclusion: DB-ACLR achieved better knee stability and clinical outcomes when compared with SB-ACLR in patients with PATS >6 mm at 3- to 4-year follow-up.

show abstract

“…This study provides initial evidence that QPS using PIVOT technology does correlate with in vivo kinematics which is useful for assessing rotatory knee stability in a noninvasive and simple manner. Several studies have demonstrated that preoperative rotatory knee instability is predictive of postoperative rotatory knee instability [17,19,30]. However, these studies were performed at time zero intraoperatively while the patient was anesthetized limiting the ability to determine in vivo kinematics following ACLR.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have demonstrated that preoperative rotatory knee instability is predictive of postoperative rotatory knee instability [17, 19, 30]. However, these studies were performed at time zero intraoperatively while the patient was anesthetized limiting the ability to determine in vivo kinematics following ACLR.…”

Section: Discussionmentioning

confidence: 99%

“…Previously, increased preoperative rotatory knee instability measured using an optical tracking system with manual load application was shown to predict increased postoperative rotatory knee instability following ACL reconstruction (ACLR) [30]. Additionally, the relative preoperative tibial acceleration compared to the contralateral, uninjured knee has been shown to predict pathologic rotatory knee instability after ACLR while the tibial acceleration of the uninjured knee has been shown to predict the absolute postoperative knee laxity following double bundle ACLR with an inertial sensor [17, 19]. Lateral extraarticular tenodesis (LET) has been proposed as a viable adjunct procedure with previous studies demonstrating improved restoration of rotatory knee instability following ACLR with LET or anterolateral ligament reconstruction compared to isolated ACLR when measured intraoperatively with an inertial sensor [9, 11, 18, 35].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Preoperative quantitative pivot shift does not correlate with in vivo kinematics following ACL reconstruction with or without lateral extraarticular tenodesis

Gibbs

Hughes

Popchak

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

PurposeQuantitative pivot shift (QPS) testing using PIVOT technology can detect high‐ and low‐grade rotatory knee instability following anterior cruciate ligament injury or reconstruction (ACLR). The aim of this project was to determine if preoperative QPS correlates with postoperative knee kinematics in the operative and contralateral, healthy extremity following ACLR with or without lateral extraarticular tenodesis (LET) using a highly precise in vivo analysis system. A positive correlation between preoperative QPS and postoperative tibial translation and rotation following ACLR with or without LET in the operative and healthy, contralateral extremity was hypothesized. MethodsTwenty patients with ACL injury and high‐grade rotatory knee instability were randomized to undergo anatomic ACLR with or without LET as part of a prospective randomized trial. At 6 and 12 months postoperatively, in vivo kinematic data were collected using dynamic biplanar radiography superimposed with high‐resolution computed tomography scans of patients’ knees during downhill running. Total anterior–posterior (AP) tibial translation and internal–external tibial rotation were measured during the gait cycle. Spearman’s rho was calculated for preoperative QPS and postoperative kinematics. ResultsIn the contralateral, healthy extremity, a significant positive correlation was seen between preoperative QPS and total AP tibial translation at 12 months postoperatively (rs = 0.6, p < 0.05). There were no additional significant correlations observed between preoperative QPS and postoperative knee kinematics at 6 and 12 months postoperatively in the operative and contralateral, healthy extremity for combined isolated ACLR and ACLR with LET patients as well as isolated ACLR patients or ACLR with LET patients analyzed separately. DiscussionThe main finding of this study was that there was a significant positive correlation between preoperative QPS and total AP tibial translation at 12 months postoperatively in the contralateral, healthy extremity. There were no significant correlations between preoperative QPS and postoperative in vivo kinematics at 6 and 12 months following ACLR with or without LET. This suggests that QPS as measured with PIVOT technology does correlate with healthy in vivo knee kinematics, but QPS does not correlate with in vivo kinematics following ACLR with or without LET.

show abstract

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

Cited by 8 publications

References 27 publications

Posterior tibial plateau impaction fractures are not associated with increased knee instability: a quantitative pivot shift analysis

Posterior tibial plateau impaction fractures are not associated with increased knee instability: a quantitative pivot shift analysis

Double-Bundle Versus Single-Bundle Anterior Cruciate Ligament Reconstruction in Patients With Significant Passive Anterior Tibial Subluxation

Preoperative quantitative pivot shift does not correlate with in vivo kinematics following ACL reconstruction with or without lateral extraarticular tenodesis

Contact Info

Product

Resources

About