MRI-determined anterolateral capsule injury did not affect the pivot-shift in anterior cruciate ligament-injured knees View Full Text


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Article Info

DATE

2019-02-04

AUTHORS

Nobuaki Miyaji, Yuichi Hoshino, Toshikazu Tanaka, Kyohei Nishida, Daisuke Araki, Noriyuki Kanzaki, Takehiko Matsushita, Ryosuke Kuroda

ABSTRACT

PurposeThe purpose of this study was to quantitatively compare the results of pivot-shift test between knees with anterior cruciate ligament (ACL) injury with and without anterolateral capsule (ALC) injury detected on MRI. ALC injury was hypothesized to worsen rotatory knee laxity.Methods82 patients with unilateral ACL injury were enrolled in this study. The pivot-shift test was performed under anesthesia before ACL reconstruction. Two evaluations were conducted simultaneously: IKDC clinical grading and the quantitative evaluation using an electromagnetic measurement system that determined tibial acceleration (m/s2). Two examiners identified the ALC injury on magnetic resonance imaging (MRI) and stratified patients into two groups: ALC-injured (ALC+) and ALC-intact (ALC−). ALC injury was diagnosed if the signal intensity on coronal T2-weighted sequences is increased. After confirming the reliability of the MRI, the difference in the pivot-shift between two groups was assessed.ResultsBecause of the poor agreement between examiners with respect to the ALC evaluations (κ coefficient of 0.25 and 58.5% concordance), the result from each examiner was analyzed separately. Examiner 1 found ALC injury in 42/82 knees (51%). The two groups had similar clinical grading (glide/clunk/gross: ALC+ group 21/18/3cases vs. ALC− group 21/16/3cases) (n.s.). Tibial acceleration during pivot-shift was also similar in the ALC+ (1.4 ± 1.2 m/s2) and ALC− (1.7 ± 1.3 m/s2) groups (n.s.). Examiner 2 found ALC injury in 28/82 knees (34%). Differences in clinical grading were not observed (glide/clunk/gross: ALC+ group 16/9/3 vs. ALC− group 26/25/3) (n.s.). However, the tibial acceleration in the ALC+ group (1.2 ± 0.8 m/s2) was significantly lower than that in the ALC− group (1.7 ± 1.3 m/s2, p = 0.03).ConclusionConcomitant ALC injury in knees with ACL injury was not consistently detected on MRI and did not affect rotatory knee laxity.Level of evidenceCase–control study, level III. More... »

PAGES

3426-3431

References to SciGraph publications

  • <error retrieving object. in <ERROR RETRIEVING OBJECT
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    http://scigraph.springernature.com/pub.10.1007/s00167-019-05376-8

    DOI

    http://dx.doi.org/10.1007/s00167-019-05376-8

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1111917852

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30719540


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        "description": "PurposeThe purpose of this study was to quantitatively compare the results of pivot-shift test between knees with anterior cruciate ligament (ACL) injury with and without anterolateral capsule (ALC) injury detected on MRI. ALC injury was hypothesized to worsen rotatory knee laxity.Methods82 patients with unilateral ACL injury were enrolled in this study. The pivot-shift test was performed under anesthesia before ACL reconstruction. Two evaluations were conducted simultaneously: IKDC clinical grading and the quantitative evaluation using an electromagnetic measurement system that determined tibial acceleration (m/s2). Two examiners identified the ALC injury on magnetic resonance imaging (MRI) and stratified patients into two groups: ALC-injured (ALC+) and ALC-intact (ALC\u2212). ALC injury was diagnosed if the signal intensity on coronal T2-weighted sequences is increased. After confirming the reliability of the MRI, the difference in the pivot-shift between two groups was assessed.ResultsBecause of the poor agreement between examiners with respect to the ALC evaluations (\u03ba coefficient of 0.25 and 58.5% concordance), the result from each examiner was analyzed separately. Examiner 1 found ALC injury in 42/82 knees (51%). The two groups had similar clinical grading (glide/clunk/gross: ALC+ group 21/18/3cases vs. ALC\u2212 group 21/16/3cases) (n.s.). Tibial acceleration during pivot-shift was also similar in the ALC+ (1.4\u2009\u00b1\u20091.2\u00a0m/s2) and ALC\u2212 (1.7\u2009\u00b1\u20091.3\u00a0m/s2) groups (n.s.). Examiner 2 found ALC injury in 28/82 knees (34%). Differences in clinical grading were not observed (glide/clunk/gross: ALC+ group 16/9/3 vs. ALC\u2212 group 26/25/3) (n.s.). However, the tibial acceleration in the ALC+ group (1.2\u2009\u00b1\u20090.8\u00a0m/s2) was significantly lower than that in the ALC\u2212 group (1.7\u2009\u00b1\u20091.3\u00a0m/s2, p\u2009=\u20090.03).ConclusionConcomitant ALC injury in knees with ACL injury was not consistently detected on MRI and did not affect rotatory knee laxity.Level of evidenceCase\u2013control study, level III.", 
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    35 schema:description PurposeThe purpose of this study was to quantitatively compare the results of pivot-shift test between knees with anterior cruciate ligament (ACL) injury with and without anterolateral capsule (ALC) injury detected on MRI. ALC injury was hypothesized to worsen rotatory knee laxity.Methods82 patients with unilateral ACL injury were enrolled in this study. The pivot-shift test was performed under anesthesia before ACL reconstruction. Two evaluations were conducted simultaneously: IKDC clinical grading and the quantitative evaluation using an electromagnetic measurement system that determined tibial acceleration (m/s2). Two examiners identified the ALC injury on magnetic resonance imaging (MRI) and stratified patients into two groups: ALC-injured (ALC+) and ALC-intact (ALC−). ALC injury was diagnosed if the signal intensity on coronal T2-weighted sequences is increased. After confirming the reliability of the MRI, the difference in the pivot-shift between two groups was assessed.ResultsBecause of the poor agreement between examiners with respect to the ALC evaluations (κ coefficient of 0.25 and 58.5% concordance), the result from each examiner was analyzed separately. Examiner 1 found ALC injury in 42/82 knees (51%). The two groups had similar clinical grading (glide/clunk/gross: ALC+ group 21/18/3cases vs. ALC− group 21/16/3cases) (n.s.). Tibial acceleration during pivot-shift was also similar in the ALC+ (1.4 ± 1.2 m/s2) and ALC− (1.7 ± 1.3 m/s2) groups (n.s.). Examiner 2 found ALC injury in 28/82 knees (34%). Differences in clinical grading were not observed (glide/clunk/gross: ALC+ group 16/9/3 vs. ALC− group 26/25/3) (n.s.). However, the tibial acceleration in the ALC+ group (1.2 ± 0.8 m/s2) was significantly lower than that in the ALC− group (1.7 ± 1.3 m/s2, p = 0.03).ConclusionConcomitant ALC injury in knees with ACL injury was not consistently detected on MRI and did not affect rotatory knee laxity.Level of evidenceCase–control study, level III.
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