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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2012

01-07-2012 | Knee

Optimal measurement of clinical rotational test for evaluating anterior cruciate ligament insufficiency

Authors: Yuichi Hoshino, Ryosuke Kuroda, Kouki Nagamune, Daisuke Araki, Seiji Kubo, Motoi Yamaguchi, Masahiro Kurosaka

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2012

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Abstract

Purpose

Rotational instability in ACL insufficient knee addresses the symptom or the abnormal motion which can be reproduced and subjectively evaluated in the clinical exam. Clinically available quantitative measurement for this instability has not been established due to mixed testing maneuvers and complex kinematics. The purpose was to measure knee kinematics during three manually performed rotational tests and to determine the optimal method to detect the abnormality in ACL deficient knees.

Method

Thirteen unilateral ACL deficient patients were tested by internal and external pure rotational stress tests and pivot shift test under anesthesia before scheduled ACL reconstructions. Rotation and coupled motion, i.e., tibial anteroposterior translation, were measured using an electromagnetic measurement system. Additionally, the acceleration of the tibial posterior translation during pivot shift test was calculated. The differences of these parameters between ACL intact and deficient knees were tested.

Results

Knee rotation is not different between ACL intact and deficient during both pure rotational stress test and pivot shift test. The coupled anterior tibial translation during pivot shift test was significantly different between ACL intact, 13.5 ± 4.1 mm, and deficient knees, 23.1 ± 4.4 mm, (P < 0.01) as well as the acceleration of the tibial posterior translation (1.1 ± 0.4 m/sec2 in intact knees, 3.2 ± 1.5 m/sec2 in deficient knees; P < 0.01). The coupled motion during pure rotational stress tests was similar regardless of ACL condition.

Conclusion

The rotational instability of the ACL deficiency was reproduced only by the pivot shift test and detected only by measuring the tibial anteroposterior translation and acceleration of the tibial posterior reduction.
Level of evidence Diagnostic study, Level III.
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Metadata
Title
Optimal measurement of clinical rotational test for evaluating anterior cruciate ligament insufficiency
Authors
Yuichi Hoshino
Ryosuke Kuroda
Kouki Nagamune
Daisuke Araki
Seiji Kubo
Motoi Yamaguchi
Masahiro Kurosaka
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2012
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1643-5

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