PURPOSE: Concomitant meniscus injuries in the anterior cruciate ligament (ACL) have been suggested to exacerbate rotational laxity. However, the effect is supposed to be so small, if any, that some quantitative pivot-shift measurement is needed. The purpose of this prospective study was to determine the effect of meniscus tear on rotational laxity in ACL-deficient knees by an quantitative measurement. It was hypothesized that a concomitant meniscus tear, especially a lateral one, would induce greater pivot shift. METHODS: Fifty-seven unilateral ACL-injured patients (26 men and 31 women, mean age: 24 ± 10 years) were included. The pivot-shift test was performed prior to ACL reconstruction, while a quantitative evaluation using an electromagnetic system to determine tibial acceleration and a clinical grading according to the IKDC were performed. Meniscus injuries were diagnosed arthroscopically, and concomitant meniscus tear was confirmed in 32 knees. RESULTS: The clinical grade was not different between the ACL-injured knees of patients with and without meniscus tear (n.s.). Tibial acceleration did not show a statistical significant difference (meniscus-injured knees: 1.6 ± 1.1 m/s2 versus meniscus-intact knees: 1.2 ± 0.7 m/s2, n.s.). However, the subgroup analysis demonstrated that there was increased tibial acceleration in ACL-deficient knees with lateral meniscus tear (2.1 ± 1.1 m/s2, n = 13) compared with meniscus-intact knees (p < 0.05), whereas rotational laxity did not increase in the medial meniscus-injured and bilateral-injured knees (1.2 ± 0.9 m/s2, n = 12, n.s. and 1.4 ± 1.1 m/s2, n = 7, n.s., respectively). CONCLUSION: A concomitant meniscus tear, especially a lateral meniscus tear, has a significant impact on rotational laxity in ACL-injured knees. When a large pivot shift is observed in the ACL-injured knee, a concomitant meniscus tear should be suspected and an aggressive treatment would be considered. Meniscus injuries should be inspected carefully when substantial pivot shift is encountered in ACL-injured knees. LEVEL OF EVIDENCE: Diagnostic study, Level III.
PURPOSE: Concomitant meniscus injuries in the anterior cruciate ligament (ACL) have been suggested to exacerbate rotational laxity. However, the effect is supposed to be so small, if any, that some quantitative pivot-shift measurement is needed. The purpose of this prospective study was to determine the effect of meniscus tear on rotational laxity in ACL-deficient knees by an quantitative measurement. It was hypothesized that a concomitant meniscus tear, especially a lateral one, would induce greater pivot shift. METHODS: Fifty-seven unilateral ACL-injured patients (26 men and 31 women, mean age: 24 ± 10 years) were included. The pivot-shift test was performed prior to ACL reconstruction, while a quantitative evaluation using an electromagnetic system to determine tibial acceleration and a clinical grading according to the IKDC were performed. Meniscus injuries were diagnosed arthroscopically, and concomitant meniscus tear was confirmed in 32 knees. RESULTS: The clinical grade was not different between the ACL-injured knees of patients with and without meniscus tear (n.s.). Tibial acceleration did not show a statistical significant difference (meniscus-injured knees: 1.6 ± 1.1 m/s2 versus meniscus-intact knees: 1.2 ± 0.7 m/s2, n.s.). However, the subgroup analysis demonstrated that there was increased tibial acceleration in ACL-deficient knees with lateral meniscus tear (2.1 ± 1.1 m/s2, n = 13) compared with meniscus-intact knees (p < 0.05), whereas rotational laxity did not increase in the medial meniscus-injured and bilateral-injured knees (1.2 ± 0.9 m/s2, n = 12, n.s. and 1.4 ± 1.1 m/s2, n = 7, n.s., respectively). CONCLUSION: A concomitant meniscus tear, especially a lateral meniscus tear, has a significant impact on rotational laxity in ACL-injured knees. When a large pivot shift is observed in the ACL-injured knee, a concomitant meniscus tear should be suspected and an aggressive treatment would be considered. Meniscus injuries should be inspected carefully when substantial pivot shift is encountered in ACL-injured knees. LEVEL OF EVIDENCE: Diagnostic study, Level III.
Authors: Theresa Diermeier; Sean J Meredith; James J Irrgang; Stefano Zaffagnini; Ryosuke Kuroda; Yuichi Hochino; Kristian Samuelsson; Clair Nicole Smith; Adam Popchak; Volker Musahl; 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; Ryosuke Kuroda; Yuichi Hochino; Alberto Grassi; Giulio Maria Marcheggiani Muccioli; Nicola Lopomo; Cecilia Signorelli; Federico Raggi; Stefano Zaffagnini; Alexandra Horvath; Eleonor Svantesson; Eric Hamrin Senorski; David Sundemo; Haukur Bjoernsson; Mattias Ahlden; Neel Desai; Kristian Samuelsson; Jon Karlsson Journal: Orthop J Sports Med Date: 2020-07-07
Authors: Theresa Diermeier; Benjamin B Rothrauff; Lars Engebretsen; Andrew D Lynch; Olufemi R Ayeni; Mark V Paterno; John W Xerogeanes; Freddie H Fu; Jon Karlsson; Volker Musahl; Eleonor Svantesson; Eric Hamrin Senorski; Thomas Rauer; Sean J Meredith Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-05-09 Impact factor: 4.342
Authors: Lachlan M Batty; Andrew Firth; Gilbert Moatshe; Dianne M Bryant; Mark Heard; Robert G McCormack; Alex Rezansoff; Devin C Peterson; Davide Bardana; Peter B MacDonald; Peter C M Verdonk; Tim Spalding; Alan M J Getgood; Kevin Willits; Trevor Birmingham; Chris Hewison; Stacey Wanlin; Andrew Firth; Ryan Pinto; Ashley Martindale; Lindsey O'Neill; Morgan Jennings; Michal Daniluk; Dory Boyer; Mauri Zomar; Karyn Moon; Raely Pritchett; Krystan Payne; Brenda Fan; Bindu Mohan; Gregory M Buchko; Laurie A Hiemstra; Sarah Kerslake; Jeremy Tynedal; Greg Stranges; Sheila Mcrae; LeeAnne Gullett; Holly Brown; Alexandra Legary; Alison Longo; Mat Christian; Celeste Ferguson; Nick Mohtadi; Rhamona Barber; Denise Chan; Caitlin Campbell; Alexandra Garven; Karen Pulsifer; Michelle Mayer; Nicole Simunovic; Andrew Duong; David Robinson; David Levy; Matt Skelly; Ajaykumar Shanmugaraj; Fiona Howells; Murray Tough; Pete Thompson; Andrew Metcalfe; Laura Asplin; Alisen Dube; Louise Clarkson; Jaclyn Brown; Alison Bolsover; Carolyn Bradshaw; Larissa Belgrove; Francis Millan; Sylvia Turner; Sarah Verdugo; Janet Lowe; Debra Dunne; Kerri McGowan; Charlie-Marie Suddens; Geert Declercq; Kristien Vuylsteke; Mieke Van Haver Journal: Orthop J Sports Med Date: 2021-04-06