PURPOSE: The purpose of this study was to assess the pivot-shift phenomenon during double-bundle anterior cruciate ligament (ACL) reconstruction using a navigation system. METHODS: Ninety patients who received navigated double-bundle ACL reconstruction were included in this study. The mean age of the patients was 21.9 years. During reconstruction, pivot-shift tests were performed 4 times: before reconstruction, after the posterolateral bundle fixation, after the anteromedial bundle fixation, and after the double-bundle reconstruction. Both tibial internal rotation and anterior translation under the pivot-shift test were measured at each phase by the additional functions of the navigation. The navigation system used in this study was the image-free, which does not require preoperative or intraoperative images, OrthoPilot ACL (version 2.0; B. Braun Aesculap, Tuttlingen, Germany). RESULTS: Before ACL reconstruction, average (+/- standard deviation) tibial internal rotation and anterior translation under the pivot-shift test were 23.7 degrees +/- 6.1 degrees and 5.2 +/- 2.4 mm. They were significantly decreased to 20.9 degrees +/- 6.4 degrees and 2.3 +/- 1.1 mm after the posterolateral bundle fixation, and also decreased to 22.2 degrees +/- 5.7 degrees and 2.4 +/- 1.1 mm after the anteromedial bundle fixation. There was no significant difference between the groups. After double-bundle reconstruction, they improved to 20.3 degrees +/- 6.3 degrees and 2.0 +/- 1.0 mm. CONCLUSIONS: Our results indicate that both the posterolateral and the anteromedial bundle similarly control both anterior translation and internal rotation during pivot-shift testing. Double-bundle reconstruction may further improve knee stability. LEVEL OF EVIDENCE: Level II, development of diagnostic criteria on basis of consecutive patients with universally applied reference gold standard.
PURPOSE: The purpose of this study was to assess the pivot-shift phenomenon during double-bundle anterior cruciate ligament (ACL) reconstruction using a navigation system. METHODS: Ninety patients who received navigated double-bundle ACL reconstruction were included in this study. The mean age of the patients was 21.9 years. During reconstruction, pivot-shift tests were performed 4 times: before reconstruction, after the posterolateral bundle fixation, after the anteromedial bundle fixation, and after the double-bundle reconstruction. Both tibial internal rotation and anterior translation under the pivot-shift test were measured at each phase by the additional functions of the navigation. The navigation system used in this study was the image-free, which does not require preoperative or intraoperative images, OrthoPilot ACL (version 2.0; B. Braun Aesculap, Tuttlingen, Germany). RESULTS: Before ACL reconstruction, average (+/- standard deviation) tibial internal rotation and anterior translation under the pivot-shift test were 23.7 degrees +/- 6.1 degrees and 5.2 +/- 2.4 mm. They were significantly decreased to 20.9 degrees +/- 6.4 degrees and 2.3 +/- 1.1 mm after the posterolateral bundle fixation, and also decreased to 22.2 degrees +/- 5.7 degrees and 2.4 +/- 1.1 mm after the anteromedial bundle fixation. There was no significant difference between the groups. After double-bundle reconstruction, they improved to 20.3 degrees +/- 6.3 degrees and 2.0 +/- 1.0 mm. CONCLUSIONS: Our results indicate that both the posterolateral and the anteromedial bundle similarly control both anterior translation and internal rotation during pivot-shift testing. Double-bundle reconstruction may further improve knee stability. LEVEL OF EVIDENCE: Level II, development of diagnostic criteria on basis of consecutive patients with universally applied reference gold standard.
Authors: Musa Citak; Padhraig F O'Loughlin; Mustafa Citak; Eduardo M Suero; Marianne R F Bosscher; Volker Musahl; Andrew D Pearle Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-11-15 Impact factor: 4.342
Authors: Volker Musahl; Sebastian Kopf; Stephen Rabuck; Roland Becker; Willem van der Merwe; Stefano Zaffagnini; Freddie H Fu; Jon Karlsson Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-12-30 Impact factor: 4.342
Authors: Musa Citak; Eduardo M Suero; Joshua C Rozell; Marianne Roberta Frederiek Bosscher; Julian Kuestermeyer; Andrew D Pearle Journal: Knee Surg Sports Traumatol Arthrosc Date: 2010-10-15 Impact factor: 4.342
Authors: Per Henrik Borgstrom; Keith L Markolf; Brock Foster; Frank A Petrigliano; David R McAllister Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-07-25 Impact factor: 4.342