Evidence map›Paper›PMID 30715594›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019

Education and repetition improve success rate and quantitative measures of the pivot shift test.

Jan-Hendrik Naendrup, Neel K Patel, Jason P Zlotnicki, Conor I Murphy, Richard E Debski, Volker Musahl

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Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing 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

7 citing papers in PubMed.

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4 · The record

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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

6 authors.

Jan-Hendrik NaendrupDepartment of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Center, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany. janhendrik.naendrup@gmail.com.ORCID http://orcid.org/0000-0002-6420-7938
Neel K PatelOrthopaedic Robotics Laboratory, Department of Bioengineering and Department of Orthopaedic Surgery, University of Pittsburgh, 300 Technology Drive, Pittsburgh, PA, 15219, USA.
Jason P ZlotnickiOrthopaedic Robotics Laboratory, Department of Bioengineering and Department of Orthopaedic Surgery, University of Pittsburgh, 300 Technology Drive, Pittsburgh, PA, 15219, USA.
Conor I MurphyOrthopaedic Robotics Laboratory, Department of Bioengineering and Department of Orthopaedic Surgery, University of Pittsburgh, 300 Technology Drive, Pittsburgh, PA, 15219, USA.
Richard E DebskiOrthopaedic Robotics Laboratory, Department of Bioengineering and Department of Orthopaedic Surgery, University of Pittsburgh, 300 Technology Drive, Pittsburgh, PA, 15219, USA.
Volker MusahlOrthopaedic Robotics Laboratory, Department of Bioengineering and Department of Orthopaedic Surgery, University of Pittsburgh, 300 Technology Drive, Pittsburgh, PA, 15219, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeClinicians have different techniques and varying levels of experience with the pivot shift test, introducing variability into its performance. The purpose of this study was to evaluate the influence of teaching and repetition on the success rate and anterior translation of the lateral knee compartment during the pivot shift test in a cadaveric ACL injury model.

methodsTwenty-five participants (five each of medical students, orthopaedic surgery residents, physical therapists, athletic trainers, sports medicine fellows) were recruited and a senior orthopaedic surgeon served as gold standard examiner. Each participant performed 20 pivot shift tests on lower extremity cadaveric specimens with ACL deficiency and lateral meniscectomy: 5 prior to education (baseline), 10 after watching an instructional video (passive teaching), and 5 after an interactive education session (active teaching). The anterior translation of the lateral knee compartment was recorded during each pivot shift test using electromagnetic tracking system.

resultsFor medical students and orthopaedic surgery residents, significant improvement in success rate was found when compared to baseline (12% and 24%, respectively) after both passive (36% and 60%, respectively) and active teaching (52% and 72%, respectively) (p < 0.5). Medical students and residents were the only participants that independently achieved significant increases in anterior translation of the lateral knee compartment, each tripling the respective baseline value (p < 0.5). In the entire study population, significant increases in anterior translation of the lateral knee compartment and success rate of the pivot shift test were seen with continuous repetition (p < 0.5). However, the standard deviation of anterior translation of the lateral knee compartment was more than twice the gold standard examiner's standard deviation, indicating a high degree of variability.

conclusionTeaching of the pivot shift test plays a major role in the development of a proper technique. However, variability persisted despite teaching and repetition. New methods may be needed to improve the teaching of the pivot shift test.

Indexed as

Anterior Cruciate LigamentBiomechanical PhenomenaCadaverClinical CompetenceHealth PersonnelHumansJoint InstabilityKnee JointPhysical ExaminationAnterior cruciate ligamentEducationKneeKnee biomechanicsPivot shift testRepetition

Identifiers

PMID30715594

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.