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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2012

01-04-2012 | Knee

The role of static and dynamic rotatory laxity testing in evaluating ACL injury

Authors: Volker Musahl, Romain Seil, Stefano Zaffagnini, Scott Tashman, Jon Karlsson

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2012

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Abstract

In this article, we discuss current topics for rotatory knee laxity. All tests for knee laxity have a value. Static knee laxity tests reveal information for each individual patient’s laxity status, especially compared to the contralateral side. Static knee laxity tests are simple to do, and some of them are instrumented, therefore quantifiable. Dynamic knee laxity tests are more complex. Dynamic stereo radiography (DSX) is considered the gold standard. Utilizing DSX, information can be gained on 3-D kinematics, functional joint space, and joint contact patterns. The disadvantage is that DSX is expensive and can only be performed in a laboratory environment. The pivot shift test is a unique test, because it is dynamic and easily performed in the office. However, it is subjective and only recently quantifiable. Future endeavors will attempt to improve the value of the pivot shift test by standardizing the test and improving measurement technologies, while keeping the pivot shift test simple and non-invasive.
Literature
1.
Almquist PO, Arnbjornsson A, Zatterstrom R, Ryd L, Ekdahl C, Friden T (2002) Evaluation of an external device measuring knee joint rotation: an in vivo study with simultaneous Roentgen stereometric analysis. J Orthop Res 20(3):427–432PubMedCrossRef
2.
Andersen HN, Dyhre-Poulsen P (1997) The anterior cruciate ligament does play a role in controlling axial rotation in the knee. Knee Surg Sports Traumatol Arthrosc 5(3):145–149PubMedCrossRef
3.
Andriacchi TP, Alexander EJ, Toney MK, Dyrby C, Sum J (1998) A point cluster method for in vivo motion analysis: applied to a study of knee kinematics. J Biomech Eng 120(6):743–749PubMedCrossRef
4.
Andriacchi TP, Mundermann A, Smith RL, Alexander EJ, Dyrby CO, Koo S (2004) A framework for the in vivo pathomechanics of osteoarthritis at the knee. Ann Biomed Eng 32(3):447–457PubMedCrossRef
5.
Bergfeld J (2011) What have we learned over the last 30 years of ACL reconstruction? In: Panther global summit, Pittsburgh, USA
6.
Bignozzi S, Zaffagnini S, Lopomo N, Martelli S, Iacono F, Marcacci M (2009) Does a lateral plasty control coupled translation during antero-posterior stress in single-bundle ACL reconstruction? An in vivo study. Knee Surg Sports Traumatol Arthrosc 17(1):65–70PubMedCrossRef
7.
Branch TP, Browne JE, Campbell JD, Siebold R, Freedberg HI, Arendt EA, Lavoie F, Neyret P, Jacobs CA (2009) Rotational laxity greater in patients with contralateral anterior cruciate ligament injury than healthy volunteers. Knee Surg Sports Traumatol Arthrosc 18(10):1379–1384PubMedCrossRef
8.
Bull AM, Amis AA (1998) Knee joint motion: description and measurement. Proc Inst Mech Eng H 212(5):357–372PubMed
9.
Bull AM, Earnshaw PH, Smith A, Katchburian MV, Hassan AN, Amis AA (2002) Intraoperative measurement of knee kinematics in reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br 84(7):1075–1081PubMedCrossRef
10.
Burkart A, Debski RE, McMahon PJ, Rudy T, Fu FH, Musahl V, van Scyoc A, Woo SL (2001) Precision of ACL tunnel placement using traditional and robotic techniques. Comput Aided Surg. 6(5):270–278PubMedCrossRef
11.
Fetto JF, Marshall JL (1979) Injury to the anterior cruciate ligament producing the pivot-shift sign. J Bone Joint Surg Am 61(5):710–714PubMed
12.
Fleming BC, Brattbakk B, Peura GD, Badger GJ, Beynnon BD (2002) Measurement of anterior–posterior knee laxity: a comparison of three techniques. J Orthop Res 20(3):421–426PubMedCrossRef
13.
Harter RA, Osternig LR, Singer KM, James SL, Larson RL, Jones DC (1988) Long-term evaluation of knee stability and function following surgical reconstruction for anterior cruciate ligament insufficiency. Am J Sports Med 16(5):434–443PubMedCrossRef
14.
Hoshino Y, Araujo P, Irrgang JJ, Fu FH, Musahl V (2011) A simple image analysis to quantify the lateral pivot shift test. In: Panther global summit, Pittsburgh, USA
15.
Hoshino Y, Kuroda R, Nagamune K, Yagi M, Mizuno K, Yamaguchi M, Muratsu H, Yoshiya S, Kurosaka M (2007) In vivo measurement of the pivot-shift test in the anterior cruciate ligament-deficient knee using an electromagnetic device. Am J Sports Med 35(7):1098–1104PubMedCrossRef
16.
Kocher MS, Micheli LJ, Zurakowski D, Luke A (2002) Partial tears of the anterior cruciate ligament in children and adolescents. Am J Sports Med 30(5):697–703PubMed
17.
Lane JG, Irby SE, Kaufman K, Rangger C, Daniel DM (1994) The anterior cruciate ligament in controlling axial rotation. An evaluation of its effect. Am J Sports Med 22(2):289–293PubMedCrossRef
18.
Lopomo N, Zaffagnini S, Bignozzi S, Visani A, Marcacci M (2010) Pivot-shift test: analysis and quantification of knee laxity parameters using a navigation system. J Orthop Res 28(2):164–169PubMed
19.
Lopomo N, Zaffagnini S, Signorelli C, Bignozzi S, Giordano G, Marcheggiani Muccioli GM, Visani A (2011) An original clinical methodology for non-invasive assessment of pivot-shift test. Comput Methods Biomech Biomed Engin. doi:10.​1080/​10255842.​2011.​591788
20.
Lorbach O, Pape D, Maas S, Zerbe T, Busch L, Kohn D, Seil R (2010) Influence of the anteromedial and posterolateral bundles of the anterior cruciate ligament on external and internal tibiofemoral rotation. Am J Sports Med 38(4):721–727PubMedCrossRef
21.
Lorbach O, Wilmes P, Maas S, Zerbe T, Busch L, Kohn D, Seil R (2009) A non-invasive device to objectively measure tibial rotation: verification of the device. Knee Surg Sports Traumatol Arthrosc 17(7):756–762PubMedCrossRef
22.
Musahl V, Ayeni OR, Citak M, Irrgang JJ, Pearle AD, Wickiewicz TL (2010) The influence of bony morphology on the magnitude of the pivot shift. Knee Surg Sports Traumatol Arthrosc 18(9):1232–1238PubMedCrossRef
23.
Musahl V, Bell KM, Tsai AG, Costic RS, Allaire R, Zantop T, Irrgang JJ, Fu FH (2007) Development of a simple device for measurement of rotational knee laxity. Knee Surg Sports Traumatol Arthrosc 15(8):1009–1012PubMedCrossRef
24.
Musahl V, Voos JE, O’Loughlin PF, Choi D, Stueber V, Kendoff D, Pearle AD (2010) Comparing stability of different single- and double-bundle anterior cruciate ligament reconstruction techniques: a cadaveric study using navigation. Arthroscopy 26(9 Suppl):S41–S48PubMed
25.
Nielsen S, Ovesen J, Rasmussen O (1984) The anterior cruciate ligament of the knee: an experimental study of its importance in rotatory knee instability. Arch Orthop Trauma Surg 103(3):170–174PubMedCrossRef
26.
Olsen OE, Myklebust G, Engebretsen L, Bahr R (2004) Injury mechanisms for anterior cruciate ligament injuries in team handball: a systematic video analysis. Am J Sports Med 32(4):1002–1012PubMedCrossRef
27.
Robert H, Nouveau S, Gageot S, Gagniere B (2009) A new knee arthrometer, the GNRB: experience in ACL complete and partial tears. Orthop Traumatol Surg Res. 95(3):171–176PubMedCrossRef
28.
Sakane M, Fox RJ, Woo SL, Livesay GA, Li G, Fu FH (1997) In situ forces in the anterior cruciate ligament and its bundles in response to anterior tibial loads. J Orthop Res 15(2):285–293PubMedCrossRef
29.
Seil R, Mouton C, Pape D, Lorbach O, Maas S, Theisen D (2011) Static rotational knee laxity evaluations. In: ESSKA symposium, in AGA congress, Regensburg, Germany
30.
Shultz SJ, Beynnon BD, Schmitz RJ (2009) Sex differences in coupled knee motions during the transition from non-weight bearing to weight bearing. J Orthop Res 27(6):717–723PubMedCrossRef
31.
Shultz SJ, Shimokochi Y, Nguyen AD, Schmitz RJ, Beynnon BD, Perrin DH (2007) Measurement of varus–valgus and internal–external rotational knee laxities in vivo—part I: assessment of measurement reliability and bilateral asymmetry. J Orthop Res 25(8):981–988PubMedCrossRef
32.
Slocum DB, Larson RL (1968) Rotatory instability of the knee. Its pathogenesis and a clinical test to demonstrate its presence. J Bone Joint Surg Am 50(2):211–225PubMed
33.
Snyder-Mackler L, Fitzgerald GK, Bartolozzi AR III, Ciccotti MG (1997) The relationship between passive joint laxity and functional outcome after anterior cruciate ligament injury. Am J Sports Med 25(2):191–195PubMedCrossRef
34.
Stagni R, Fantozzi S, Cappello A, Leardini A (2005) Quantification of soft tissue artefact in motion analysis by combining 3D fluoroscopy and stereophotogrammetry: a study on two subjects. Clin Biomech (Bristol, Avon). 20(3):320–329
35.
Tashman S, Collon D, Anderson K, Kolowich P, Anderst W (2004) Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med 32(4):975–983PubMedCrossRef
36.
Tashman S, Kolowich P, Collon D, Anderson K, Anderst W (2007) Dynamic function of the ACL-reconstructed knee during running. Clin Orthop Relat Res. 454:66–73PubMedCrossRef
37.
Tashman S, Kopf S, Fu FH (2008) The kinematic basis of ACL reconstruction. Oper Tech Sports Med. 16(3):116–118PubMedCrossRef
38.
Wang CJ, Walker PS (1974) Rotatory laxity of the human knee joint. J Bone Joint Surg Am 56(1):161–170PubMed
39.
Zaffagnini S, Bignozzi S, Martelli S, Lopomo N, Marcacci M (2007) Does ACL reconstruction restore knee stability in combined lesions?: an in vivo study. Clin Orthop Relat Res. 454:95–99PubMedCrossRef
40.
Zaffagnini S, Martelli S, Falcioni B, Motta M, Marcacci M (2000) Rotational laxity after anterior cruciate ligament injury by kinematic evaluation of clinical tests. J Med Eng Technol 24(5):230–236PubMedCrossRef
41.
Zantop T, Herbort M, Raschke MJ, Fu FH, Petersen W (2007) The role of the anteromedial and posterolateral bundles of the anterior cruciate ligament in anterior tibial translation and internal rotation. Am J Sports Med 35(2):223–227PubMedCrossRef
42.
Zarins B, Rowe CR, Harris BA, Watkins MP (1983) Rotational motion of the knee. Am J Sports Med 11(3):152–156PubMedCrossRef
Metadata
Title
The role of static and dynamic rotatory laxity testing in evaluating ACL injury
Authors
Volker Musahl
Romain Seil
Stefano Zaffagnini
Scott Tashman
Jon Karlsson
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2012
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1830-4

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