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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 2/2021

01-02-2021 | KNEE

Knee laxity, lateral meniscus tear and distal femur morphology influence pivot shift test grade in ACL injury patients

Authors: Weiding Cui, Yusuke Nakagawa, Hiroki Katagiri, Koji Otabe, Toshiyuki Ohara, Mikio Shioda, Yuji Kohno, Takashi Hoshino, Aritoshi Yoshihara, Ichiro Sekiya, Hideyuki Koga

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2021

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Abstract

Purpose

Although several factors have been considered to be associated with pivot shift test grade in ACL injured patients, a conclusion regarding which factors contribute to the pivot shift test grade has not been reached. The purpose of this study was to identify factors associated with preoperative pivot shift test grade.

Methods

Three hundred and sixty-six consecutive patients who underwent ACL reconstruction in our hospital were enrolled in the study. Patients were divided into two groups on the basis of preoperative pivot shift test grade (Mild: grade 0–3, Severe: grade 4–6). First, 13 independent variables (age, gender, period from injury to surgery, hyperextension, KT measurement, contralateral side pivot shift test grade, medial and lateral tibial slope, lateral condyle length, lateral condyle height, distal femoral condyle offset, medial and lateral meniscus tear) were analyzed by one-way ANOVA and Chi-squared test. Binary Logistic regression was then performed based on the results of univariate analyses (independent variables of p < 0.2 were included).

Results

Hyperextension, lateral meniscus tear, contralateral side pivot shift test grade, distal femoral condyle offset and KT measurement were identified as risk factors for preoperative pivot shift grade via logistic regression analysis.

Conclusion

The current study revealed that hyperextension, lateral meniscus tear, contralateral side pivot shift test grade, distal femoral condyle offset and anterior instability were associated with preoperative pivot shift grade. Patients with above factors that cannot be modified during surgery may need special consideration when ACL reconstruction is performed, as greater preoperative pivot shift has been proven to be a risk factor for residual pivot shift after ACL reconstruction.

Level of evidence

III.
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Metadata
Title
Knee laxity, lateral meniscus tear and distal femur morphology influence pivot shift test grade in ACL injury patients
Authors
Weiding Cui
Yusuke Nakagawa
Hiroki Katagiri
Koji Otabe
Toshiyuki Ohara
Mikio Shioda
Yuji Kohno
Takashi Hoshino
Aritoshi Yoshihara
Ichiro Sekiya
Hideyuki Koga
Publication date
01-02-2021
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2021
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-020-05994-7

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