Kanto Nagai1, Yuichi Hoshino2, Yuichiro Nishizawa1, Daisuke Araki1, Takehiko Matsushita1, Tomoyuki Matsumoto1, Koji Takayama1, Kouki Nagamune3, Masahiro Kurosaka1, Ryosuke Kuroda4. 1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. 2. Department of Orthopaedic Surgery, Kobe Kaisei Hospital, Kobe, Japan. 3. Department of Human and Artificial Intelligent Systems, Graduate School of Engineering, University of Fukui, Fukui, Japan. 4. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. kurodar@med.kobe-u.ac.jp.
Abstract
PURPOSE: Tibial acceleration during the pivot shift test is a potential quantitative parameter to evaluate rotational laxity of anterior cruciate ligament (ACL) insufficiency. However, clinical application of this measurement has not been fully examined. This study aimed to measure and compare tibial acceleration before and after ACL reconstruction (ACLR) in ACL-injured patients. We hypothesized tibial acceleration would be reduced by ACLR and tibial acceleration would be consistent in the same knee at different time points. METHODS: Seventy ACL-injured patients who underwent ACLR were enrolled. Tibial acceleration during the pivot shift test was measured using an electromagnetic measurement system before ALCR and at the second-look arthroscopy 1 year post-operatively. Tibial acceleration was compared to clinical grading and between ACL-injured/ACL-reconstructed and contralateral knees. RESULTS: Pre-operative tibial acceleration was increased stepwise with the increase in clinical grading (P < 0.01). Tibial acceleration in ACL-injured knee (1.9 ± 1.2 m/s(2)) was larger than that in the contralateral knee (0.8 ± 0.3 m/s(2), P < 0.01), and reduced to 0.9 ± 0.3 m/s(2) post-operatively (P < 0.01). There was no difference between ACL-reconstructed and contralateral knee (n.s.). Tibial acceleration in contralateral knees was consistent pre- and post-operatively (n.s.). CONCLUSION: Tibial acceleration measurement demonstrated increased rotational laxity in ACL-injured knees and its reduction by ALCR. Additionally, consistent measurements were obtained in ACL-intact knees at different time points. Therefore, tibial acceleration during the pivot shift test could provide quantitative evaluation of rotational stability before and after ACL reconstruction. LEVEL OF EVIDENCE: III.
PURPOSE: Tibial acceleration during the pivot shift test is a potential quantitative parameter to evaluate rotational laxity of anterior cruciate ligament (ACL) insufficiency. However, clinical application of this measurement has not been fully examined. This study aimed to measure and compare tibial acceleration before and after ACL reconstruction (ACLR) in ACL-injured patients. We hypothesized tibial acceleration would be reduced by ACLR and tibial acceleration would be consistent in the same knee at different time points. METHODS: Seventy ACL-injured patients who underwent ACLR were enrolled. Tibial acceleration during the pivot shift test was measured using an electromagnetic measurement system before ALCR and at the second-look arthroscopy 1 year post-operatively. Tibial acceleration was compared to clinical grading and between ACL-injured/ACL-reconstructed and contralateral knees. RESULTS: Pre-operative tibial acceleration was increased stepwise with the increase in clinical grading (P < 0.01). Tibial acceleration in ACL-injured knee (1.9 ± 1.2 m/s(2)) was larger than that in the contralateral knee (0.8 ± 0.3 m/s(2), P < 0.01), and reduced to 0.9 ± 0.3 m/s(2) post-operatively (P < 0.01). There was no difference between ACL-reconstructed and contralateral knee (n.s.). Tibial acceleration in contralateral knees was consistent pre- and post-operatively (n.s.). CONCLUSION: Tibial acceleration measurement demonstrated increased rotational laxity in ACL-injured knees and its reduction by ALCR. Additionally, consistent measurements were obtained in ACL-intact knees at different time points. Therefore, tibial acceleration during the pivot shift test could provide quantitative evaluation of rotational stability before and after ACL reconstruction. LEVEL OF EVIDENCE: III.
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Authors: Stefano Zaffagnini; Cecilia Signorelli; Alberto Grassi; Yuichi Hoshino; Ryosuke Kuroda; Darren de Sa; David Sundemo; Kristian Samuelsson; Volker Musahl; Jon Karlsson; Andrew Sheean; Jeremy M Burnham; Jayson Lian; Clair Smith; Adam Popchak; Elmar Herbst; Thomas Pfeiffer; Paulo Araujo; Alicia Oostdyk; Daniel Guenther; Bruno Ohashi; James J Irrgang; Freddie H Fu; Kouki Nagamune; Masahiro Kurosaka; Giulio Maria Marcheggiani Muccioli; Nicola Lopomo; Federico Raggi; Eleonor Svantesson; Eric Hamrin Senorski; Haukur Bjoernsson; Mattias Ahlden; Neel Desai Journal: Orthop J Sports Med Date: 2018-12-18