Evidence map›Paper›PMID 27095250›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017

Analysis of the influence of anaesthesia on the clinical and quantitative assessment of the pivot shift: a multicenter international study.

Nicola Lopomo, Cecilia Signorelli, Amir Ata Rahnemai-Azar, Federico Raggi, Yuichi Hoshino, Kristian Samuelsson, Volker Musahl, Jon Karlsson, Ryosuke Kuroda, Stefano Zaffagnini and 1 more

Abstract readClinical TrialComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed.

  1. Global rotation has high sensitivity in ACL lesions within stress MRI.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2017
    Trial
  2. Article
  3. Article
  4. Article
  5. Article
  6. Quantitative assessment of the pivot shift test with smartphone accelerometer.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020
    Article
  7. Article
  8. Article
  9. [Research progress in anterolateral ligament of knee].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2020
    Review
  10. Article
  11. Triaxial accelerometer evaluation is correlated with IKDC grade of pivot shift.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020
    Article
  12. Article
  13. Review
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  15. Article
  16. Correlation between quantitative pivot shift and generalized joint laxity: a prospective multicenter study of ACL ruptures.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018
    Observational
  17. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Nicola LopomoDipartimento di Ingegneria dell'Informazione, Università degli Studi di Brescia, Brescia, Italy. nicola.lopomo@unibs.it.
Cecilia SignorelliLaboratorio di Biomeccanica e Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Bologna, Italy.
Amir Ata Rahnemai-AzarDepartment of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Federico RaggiLaboratorio di Biomeccanica e Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Bologna, Italy.
Yuichi HoshinoDepartment of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan.
Kristian SamuelssonDepartment of Orthopaedics, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
Volker MusahlDepartment of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Jon KarlssonDepartment of Orthopaedics, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
Ryosuke KurodaDepartment of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan.
Stefano ZaffagniniLaboratorio di Biomeccanica e Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Bologna, Italy.
PIVOT Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe main goal of this work was to evaluate the pivot shift test in awake and anesthetized patients by using two different quantitative methodologies and comparing the results with the standard clinical grading, taking advantage of a multicenter international study.

methodsPatients between 16 and 50 years of age undergoing primary unilateral single-bundle anterior cruciate ligament (ACL) reconstruction were considered eligible. The pivot shift test was performed pre-operatively, with the patient awake and again with the patient under general anaesthesia. The pivot shift test was clinically graded as defined by the International Knee Documentation Committee. The instrumented assessment was performed by using two non-invasive acquisition systems; specifically, a system exploiting an inertial sensor and a video-based application developed on a commercial tablet using skin markers. Lateral compartment translation and the tibial acceleration reached during joint reduction were used as quantitative parameters.

resultsA total of 103 patients were enrolled in the study. Statistically significant difference was found between the distributions of clinical grade evaluated in awake patients and those under general anaesthesia (P < 0.01). Comparing awake patients to those under general anaesthesia, lower values were found both for tibial acceleration (3.7 ± 1.5 vs 6.0 ± 4.6 m/s

conclusionsThis study indicated that significant differences in the grading of the pivot shift test exist between awake and anesthetized patients, regardless of the use of quantitative instruments during the evaluation. Actual clinical assessment reported indeed its weakness, presenting subjective variability and dependence on tester's experience. However, several factors might influence the validity of awake examination such as experience level of examiner and cultural factors, as seen in this international multicenter study. LEVEL OF EVIDENCE: Prospective comparative study, Level II.

Indexed as

Anesthesia, GeneralAdolescentAdultAnterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionFemaleHumansJoint InstabilityKnee JointMaleMiddle AgedPhysical ExaminationPreoperative PeriodProspective StudiesRange of Motion, ArticularYoung AdultAccelerationACLAnaesthesiaAnterior cruciate ligamentImage analysisInertial sensorPivot shiftTranslation

Identifiers

PMID27095250

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.