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High-grade rotatory knee laxity may be predictable in ACL injuries

Artikel i vetenskaplig tidskrift
Författare V. Musahl
J. Burnham
J. Lian
A. Popchak
Eleonor Svantesson
R. Kuroda
S. Zaffagnini
Kristian Samuelsson
Publicerad i Knee Surgery Sports Traumatology Arthroscopy
Volym 26
Nummer/häfte 12
Sidor 3762-3769
ISSN 0942-2056
Publiceringsår 2018
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för ortopedi
Sidor 3762-3769
Språk en
Länkar dx.doi.org/10.1007/s00167-018-5019-...
Ämnesord ACL, Anterior cruciate ligament, Pivot shift, Image analysis, Translation, Inertial sensor, Acceleration, pivot shift phenomenon, kt-1000 arthrometer, tibial slope, rolimeter, strain
Ämneskategorier Ortopedi

Sammanfattning

Purpose Lateral compartment acceleration and translation have been used to quantify rotatory knee laxity in the setting of anterior cruciate ligament (ACL) injury; however, their relationship remains elusive. The purpose of this study was to examine the correlation between lateral compartment acceleration and translation during pivot shift testing. It was hypothesized that a correlation would exist in ACL-injured and uninjured knees, irrespective of sex, but would be greatest in knees with combined ACL and lateral meniscus tear. Methods Seventy-seven patients (34 females, 25.2 +/- 9.0 years) undergoing primary single-bundle ACL reconstruction were prospectively enrolled in a 2-year study across four international centers. Patients underwent preoperative examination under anesthesia of the injured and uninjured knee using Image Analysis software and surface mounted accelerometer. Results A moderate correlation between lateral compartment acceleration and translation was observed in ACL-injured knees [rho = 0.36, p < 0.05), but not in uninjured knees (rho = 0.17, not significant (n.s.)]. A moderate correlation between acceleration and translation was demonstrated in ACL-injured knees with lateral meniscus tears (rho = 0.53, p < 0.05), but not in knees with isolated ACL-injury (rho = 0.32, n.s.), ACL and medial meniscus tears (rho = 0.14, n.s.), or ACL and combined medial and lateral meniscus tears (rho = 0.40, n.s.). A moderate correlation between acceleration and translation was seen in males (rho = 0.51, p < 0.05), but not in females (rho = 0.21, n.s.). Largest correlations were observed in males with ACL and lateral meniscus tears (rho = 0.75, p < 0.05). Conclusion Lateral compartment acceleration and translation were moderately correlated in ACL-injured knees, but largely correlated in males with combined ACL and lateral meniscus tears. ACL and lateral meniscus injury in males might, therefore, be suspected when both lateral compartment acceleration and translation are elevated. Surgeons should have a greater degree of suspicion for high-grade rotatory knee laxity in ACL-injured males with concomitant lateral meniscus tears. Future studies should investigate how these two distinct components of rotatory knee laxity-lateral compartment acceleration and translation-are correlated with patient outcomes and affected by ACL surgery.

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