ArticleJournal of experimental orthopaedics2019
Influence of knee position and examiner-induced motion on the kinematics of the pivot shift.
Article in Journal of experimental orthopaedics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Internal Rotation Measurement of the Knee with Polymer-Based Capacitive Strain Gauges versus Mechanical Rotation Measurement Taking Gender Differences into Account: A Comparative Analysis.Life (Basel, Switzerland) · 2024Article
- Pivot shift intraoperative quantitative assessment using a smartphone accelerometer in ACL deficient knees.Journal of experimental orthopaedics · 2023Article
- Laxity measurement of internal knee rotation after primary anterior cruciate ligament rupture versus rerupture.Archives of orthopaedic and trauma surgery · 2022Article
- Anatomy, Biomechanics, and Reconstruction of the Anterolateral Ligament of the Knee Joint.Medicina (Kaunas, Lithuania) · 2022Review
- Is the KiRA Device Useful in Quantifying the Pivot Shift in Anterior Cruciate Ligament-Deficient Knees?Orthopaedic journal of sports medicine · 2021Article
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Authors and funding
6 authors.
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Abstract
backgroundGrading of the pivot shift test varies significantly depending on the examiner's technique. Thus, the purpose of this study was to determine the influence of knee starting position and the magnitude of motion during the reduction event on the magnitude of the pivot shift test.
methodsTwenty-five clinical providers each performed a total of twenty pivot shift tests on one of two fresh-frozen cadaveric full lower extremity specimens with different grades of rotatory knee laxity. By means of ACL transection and lateral meniscectomy, one specimen was prepared to have a high-grade pivot shift and one to have a low-grade pivot shift. Six-degree-of-freedom kinematics were recorded during each pivot shift test using an electromagnetic-tracking-system. Successful pivot shift tests were defined and selected using an automated, mathematical algorithm based on the exceeding of a threshold value of anterior translation of the lateral knee compartment. The kinematics were correlated with the magnitude of anterior translation of the lateral knee compartment based on varying degrees of rotatory knee laxity using the Pearson correlation coefficient.
resultsOnly mild correlations between anterior translation of the lateral knee compartment and internal tibial rotation at the start of the reduction event were observed in both specimens. The ability to generate a successful reduction event was significantly dependent on the rotatory knee laxity, with a 54% success rate on the high-laxity specimen compared to a 30% success rate on the low-laxity specimen (p < 0.001). Nearly 80% of the variability of the anterior translation of the lateral knee compartment in both specimens was accounted for by external rotation during the reduction event (r = 0.847; p < 0.001). Varus rotation during the reduction event also showed a strong correlation with the anterior translation of the lateral knee compartment in the low-laxity specimen (r = 0.835; p < 0.001).
conclusionMagnitude of motion during the reduction event affected the magnitude of anterior translation of the lateral knee compartment more than the starting position. External rotation during the reduction event accounted for most of the variability in the pivot shift test. More uniform maneuvers and improved teaching are essential to generate repeatable quantitative results of the pivot shift test.
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