Lateral compartment translation predicts the grade of pivot shift: a cadaveric and clinical analysis

被引:124
作者
Bedi, Asheesh [2 ]
Musahl, Volker [2 ]
Lane, Clayton [2 ]
Citak, Musa [2 ]
Warren, Russell F. [2 ]
Pearle, Andrew D. [1 ,2 ]
机构
[1] Hosp Special Surg, Sports Med & Shoulder Serv, Comp Assisted Surg Ctr, New York, NY 10021 USA
[2] Hosp Special Surg, Dept Orthopaed, New York, NY 10021 USA
关键词
Pivot shift; Navigation; ACL; ANTERIOR CRUCIATE LIGAMENT; IN-VIVO MEASUREMENT; ACL RECONSTRUCTION; NAVIGATION SYSTEM; DEFICIENT KNEE; FOLLOW-UP; INSUFFICIENCY; RELIABILITY; KINEMATICS; RUPTURES;
D O I
10.1007/s00167-010-1160-y
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Anterior translation of the lateral compartment was hypothesized to correlate with the clinical grade of a pivot shift maneuver. Using a computer-assisted navigation system, this hypothesis was tested by recording the maximum anterior tibial translation in the medial and lateral compartment as well as the arc of rotation during the pivot shift maneuver. One hundred and fifty-four pivot shift examinations were performed on cadavers with various degrees of instability, and 24 pivot shift exams were performed on patients under anesthesia before and after ACL reconstruction. In all positive pivot shift exams, anterior tibial translations were found to be higher on in the lateral compartment compared to the medial compartment. In addition, an excellent correlation was found between the amount of lateral compartment translation and the clinical grade of the pivot shift; medial compartment translations and amount of knee rotation could not distinguish between clinical grades. Finally, a threshold of 6-7 mm of anterior tibial translation in the lateral compartment was necessary to produce a positive pivot shift. Taken together, these data suggest that monitoring lateral compartment translations during a pivot shift exam may be a convenient means to evaluate the outcomes of ACL surgery and that requisite increases in anterior translation of the lateral compartment are necessary for each progressive clinical grade of the pivot shift examination.
引用
收藏
页码:1269 / 1276
页数:8
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