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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2018

Open Access 01-08-2018 | Knee

Correlation between quantitative pivot shift and generalized joint laxity: a prospective multicenter study of ACL ruptures

Authors: David Sundemo, Anna Blom, Yuichi Hoshino, Ryosuke Kuroda, Nicola Francesco Lopomo, Stefano Zaffagnini, Volker Musahl, James J. Irrgang, Jón Karlsson, Kristian Samuelsson, The PIVOT Study Group

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2018

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Abstract

Purpose

To investigate whether an increased magnitude of quantitative rotatory knee laxity is associated with a greater level of generalized joint laxity in ACL-injured and contralateral knees.

Methods

A total of 103 patients were enrolled across four international centers to undergo anatomic ACL reconstruction. Rotatory knee laxity was evaluated preoperatively, both in the awake state and under anesthesia, using the standardized pivot shift test. Two devices were used to quantify rotatory knee laxity; an inertial sensor, measuring the joint acceleration, and an image analysis system, measuring the lateral compartment translation of the tibia. The presence of generalized joint laxity was determined using the Beighton Hypermobility Score. The correlation between the level of generalized joint laxity and the magnitude of rotatory knee laxity was calculated for both the involved knee and the non-involved knee. Further, patients were dichotomized into low (0–4) or high (5–9) Beighton Score groups. Alpha was set at < 0.05.

Results

Ninety-six patients had complete datasets, 83 and 13 in the low and high Beighton Score groups respectively. In anesthetized patients, there was a significant correlation between the degree of Beighton Score and quantitative pivot shift when analyzing the non-involved knee using the image analysis system (r = 0.235, p < 0.05). When analyzing the same knee, multivariate analysis adjusted for meniscal injury, age and gender revealed an increased odds ratio for patients with increased lateral compartment translation to be part of the high Beighton Score group (OR 1.86, 95% CI 1.10–3.17, p < 0.05). No other correlation was significant. When analyzing the dichotomized subgroups, no significant correlations could be established.

Conclusion

The findings in this study suggest that there is a weak correlation between generalized joint laxity and the contralateral healthy knee, indicating increased rotatory knee laxity in these patients. Generalized joint laxity does not appear to correlate with rotatory knee laxity in ACL-injured knees.

Level of evidence

Prospective cohort study; level of evidence, 2.
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Metadata
Title
Correlation between quantitative pivot shift and generalized joint laxity: a prospective multicenter study of ACL ruptures
Authors
David Sundemo
Anna Blom
Yuichi Hoshino
Ryosuke Kuroda
Nicola Francesco Lopomo
Stefano Zaffagnini
Volker Musahl
James J. Irrgang
Jón Karlsson
Kristian Samuelsson
The PIVOT Study Group
Publication date
01-08-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4785-2

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