Guan-Yang Song1, Hui Zhang1, Guan Wu1, Jin Zhang1, Xin Liu1, Zhe Xue1, Yi Qian1, Hua Feng2. 1. Sports Medicine Service, Beijing Jishuitan Hospital, No. 31, Xin Jie Kou East Street, Xi Cheng District, Beijing, China. 2. Sports Medicine Service, Beijing Jishuitan Hospital, No. 31, Xin Jie Kou East Street, Xi Cheng District, Beijing, China. fenghua20080617@126.com.
Abstract
PURPOSE: To compare the prevalence of concomitant anterolateral ligament (ALL) injury between patients with high-grade (grades II and III) pivot-shift and those with low-grade (grades 0 and I) pivot-shift phenomenon after acute anterior cruciate ligament (ACL) injuries. METHODS: Sixty-eight patients with an acute ACL injury who showed high-grade (grades II and III) pivot-shift phenomenon were enrolled as the study group. They were matched in a 1:1 fashion to another 68 ACL-injured control participants who showed low-grade (grades 0 and I) pivot-shift phenomenon during the same study period. Patients were matched by age, sex, and time from injury to surgery. A standardized pivot-shift test was performed under anesthesia for all the patients. Two blinded musculoskeletal radiologists reviewed the magnetic resonance imaging (MRI) scans for the presence of concomitant ALL injury. The grade of an ALL injury was divided into grade 0 (normal), grade I (sprain), grade II (partial tear), and grade III (complete tear). The prevalence and the grade of concomitant ALL injury were further compared between the study group and the control group. RESULTS: Overall, the prevalence of concomitant ALL injury in the study group (94.1%, 64/68) was significantly higher than that in the control group [60.3%, (41/68), P < 0.05]. Specifically, there were 49 patients (49/64, 76.6%) who showed grade II/III (partial/complete tear) MRI evidence of concomitant ALL injury, which was also significantly higher than that in the control group (12/41, 29.3%). CONCLUSIONS: Patients with high-grade pivot-shift phenomenon showed higher prevalence of concomitant ALL injury compared to those with low-grade pivot-shift phenomenon after acute ACL injuries. Careful assessment and proper treatment of this concomitant injury should be considered especially in knees with high-grade pivot-shift phenomenon. LEVEL OF EVIDENCE: III.
PURPOSE: To compare the prevalence of concomitant anterolateral ligament (ALL) injury between patients with high-grade (grades II and III) pivot-shift and those with low-grade (grades 0 and I) pivot-shift phenomenon after acute anterior cruciate ligament (ACL) injuries. METHODS: Sixty-eight patients with an acute ACL injury who showed high-grade (grades II and III) pivot-shift phenomenon were enrolled as the study group. They were matched in a 1:1 fashion to another 68 ACL-injured control participants who showed low-grade (grades 0 and I) pivot-shift phenomenon during the same study period. Patients were matched by age, sex, and time from injury to surgery. A standardized pivot-shift test was performed under anesthesia for all the patients. Two blinded musculoskeletal radiologists reviewed the magnetic resonance imaging (MRI) scans for the presence of concomitant ALL injury. The grade of an ALL injury was divided into grade 0 (normal), grade I (sprain), grade II (partial tear), and grade III (complete tear). The prevalence and the grade of concomitant ALL injury were further compared between the study group and the control group. RESULTS: Overall, the prevalence of concomitant ALL injury in the study group (94.1%, 64/68) was significantly higher than that in the control group [60.3%, (41/68), P < 0.05]. Specifically, there were 49 patients (49/64, 76.6%) who showed grade II/III (partial/complete tear) MRI evidence of concomitant ALL injury, which was also significantly higher than that in the control group (12/41, 29.3%). CONCLUSIONS:Patients with high-grade pivot-shift phenomenon showed higher prevalence of concomitant ALL injury compared to those with low-grade pivot-shift phenomenon after acute ACL injuries. Careful assessment and proper treatment of this concomitant injury should be considered especially in knees with high-grade pivot-shift phenomenon. LEVEL OF EVIDENCE: III.
Authors: Philip P Roessler; Karl F Schüttler; Thomas J Heyse; Dieter C Wirtz; Turgay Efe Journal: Arch Orthop Trauma Surg Date: 2015-12-29 Impact factor: 3.067
Authors: E Monaco; A Ferretti; L Labianca; B Maestri; A Speranza; M J Kelly; C D'Arrigo Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-08-30 Impact factor: 4.342
Authors: Camilo Partezani Helito; Paulo Victor Partezani Helito; Hugo Pereira Costa; Marcelo Bordalo-Rodrigues; José Ricardo Pecora; Gilberto Luis Camanho; Marco Kawamura Demange Journal: Skeletal Radiol Date: 2014-08-03 Impact factor: 2.199
Authors: Bertrand Sonnery-Cottet; Mathieu Thaunat; Benjamin Freychet; Barbara H B Pupim; Colin G Murphy; Steven Claes Journal: Am J Sports Med Date: 2015-03-04 Impact factor: 6.202
Authors: Camilo Partezani Helito; Paulo Victor Partezani Helito; Marcelo Batista Bonadio; José Ricardo Pécora; Marcelo Bordalo-Rodrigues; Gilberto Luis Camanho; Marco Kawamura Demange Journal: Orthop J Sports Med Date: 2015-12-16