Optimal measurement of clinical rotational test for evaluating anterior cruciate ligament insufficiency View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2011-08-18

AUTHORS

Yuichi Hoshino, Ryosuke Kuroda, Kouki Nagamune, Daisuke Araki, Seiji Kubo, Motoi Yamaguchi, Masahiro Kurosaka

ABSTRACT

PurposeRotational instability in ACL insufficient knee addresses the symptom or the abnormal motion which can be reproduced and subjectively evaluated in the clinical exam. Clinically available quantitative measurement for this instability has not been established due to mixed testing maneuvers and complex kinematics. The purpose was to measure knee kinematics during three manually performed rotational tests and to determine the optimal method to detect the abnormality in ACL deficient knees.MethodThirteen unilateral ACL deficient patients were tested by internal and external pure rotational stress tests and pivot shift test under anesthesia before scheduled ACL reconstructions. Rotation and coupled motion, i.e., tibial anteroposterior translation, were measured using an electromagnetic measurement system. Additionally, the acceleration of the tibial posterior translation during pivot shift test was calculated. The differences of these parameters between ACL intact and deficient knees were tested.ResultsKnee rotation is not different between ACL intact and deficient during both pure rotational stress test and pivot shift test. The coupled anterior tibial translation during pivot shift test was significantly different between ACL intact, 13.5 ± 4.1 mm, and deficient knees, 23.1 ± 4.4 mm, (P < 0.01) as well as the acceleration of the tibial posterior translation (1.1 ± 0.4 m/sec2 in intact knees, 3.2 ± 1.5 m/sec2 in deficient knees; P < 0.01). The coupled motion during pure rotational stress tests was similar regardless of ACL condition.ConclusionThe rotational instability of the ACL deficiency was reproduced only by the pivot shift test and detected only by measuring the tibial anteroposterior translation and acceleration of the tibial posterior reduction.Level of evidence Diagnostic study, Level III. More... »

PAGES

1323-1330

References to SciGraph publications

  • 2008-07-02. Rotational instability of the knee: internal tibial rotation under a simulated pivot shift test in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 2009-03-21. Reliability testing of a new device to measure tibial rotation in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2010-05-20. Monitoring surgical performance: an application of industrial quality process control to anterior cruciate ligament reconstruction in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2009-03-05. Intraoperative evaluation of anteroposterior and rotational stabilities in anterior cruciate ligament reconstruction: lower femoral tunnel placed single-bundle versus double-bundle reconstruction in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
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  • 2010-08-24. A prospective randomised study of anatomical single-bundle versus double-bundle anterior cruciate ligament reconstruction: quantitative evaluation using an electromagnetic measurement system in INTERNATIONAL ORTHOPAEDICS
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  • 2010-02-25. Combined reconstruction for posterolateral rotatory instability with anterior cruciate ligament injuries of the knee in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2009-12-15. Mechanized pivot shift test achieves greater accuracy than manual pivot shift test in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2008-03-01. In vivo analysis of the pivot shift phenomenon during computer navigated ACL reconstruction in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00167-011-1643-5

    DOI

    http://dx.doi.org/10.1007/s00167-011-1643-5

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/21850429


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    33 schema:description PurposeRotational instability in ACL insufficient knee addresses the symptom or the abnormal motion which can be reproduced and subjectively evaluated in the clinical exam. Clinically available quantitative measurement for this instability has not been established due to mixed testing maneuvers and complex kinematics. The purpose was to measure knee kinematics during three manually performed rotational tests and to determine the optimal method to detect the abnormality in ACL deficient knees.MethodThirteen unilateral ACL deficient patients were tested by internal and external pure rotational stress tests and pivot shift test under anesthesia before scheduled ACL reconstructions. Rotation and coupled motion, i.e., tibial anteroposterior translation, were measured using an electromagnetic measurement system. Additionally, the acceleration of the tibial posterior translation during pivot shift test was calculated. The differences of these parameters between ACL intact and deficient knees were tested.ResultsKnee rotation is not different between ACL intact and deficient during both pure rotational stress test and pivot shift test. The coupled anterior tibial translation during pivot shift test was significantly different between ACL intact, 13.5 ± 4.1 mm, and deficient knees, 23.1 ± 4.4 mm, (P < 0.01) as well as the acceleration of the tibial posterior translation (1.1 ± 0.4 m/sec2 in intact knees, 3.2 ± 1.5 m/sec2 in deficient knees; P < 0.01). The coupled motion during pure rotational stress tests was similar regardless of ACL condition.ConclusionThe rotational instability of the ACL deficiency was reproduced only by the pivot shift test and detected only by measuring the tibial anteroposterior translation and acceleration of the tibial posterior reduction.Level of evidence Diagnostic study, Level III.
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    40 schema:keywords ACL
    41 ACL condition
    42 ACL deficiency
    43 ACL reconstruction
    44 ACL-deficient knee
    45 ACL-deficient patients
    46 ACL-insufficient knees
    47 MethodThirteen unilateral ACL deficient patients
    48 PurposeRotational instability
    49 ResultsKnee rotation
    50 abnormal motion
    51 abnormalities
    52 acceleration
    53 anesthesia
    54 anterior cruciate ligament insufficiency
    55 anterior tibial translation
    56 anteroposterior translation
    57 available quantitative measurements
    58 clinical exam
    59 clinical rotational test
    60 complex kinematics
    61 conditions
    62 cruciate ligament insufficiency
    63 deficiency
    64 deficient knee
    65 deficient patients
    66 diagnostic studies
    67 differences
    68 electromagnetic measurement system
    69 evidence Diagnostic study
    70 exam
    71 external pure rotational stress tests
    72 instability
    73 insufficiency
    74 insufficient knee
    75 kinematics
    76 knee
    77 knee kinematics
    78 level III
    79 levels
    80 ligament insufficiency
    81 maneuvers
    82 measurement system
    83 measurements
    84 method
    85 mixed testing maneuvers
    86 motion
    87 optimal measurement
    88 optimal method
    89 parameters
    90 patients
    91 pivot shift test
    92 posterior reduction
    93 posterior translation
    94 pure rotational stress tests
    95 purpose
    96 quantitative measurements
    97 reconstruction
    98 reduction
    99 rotation
    100 rotational instability
    101 rotational stress tests
    102 rotational test
    103 shift test
    104 stress test
    105 study
    106 symptoms
    107 system
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    110 tibial anteroposterior translation
    111 tibial posterior reduction
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    116 schema:name Optimal measurement of clinical rotational test for evaluating anterior cruciate ligament insufficiency
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