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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2018

01-12-2018 | Knee

Risk factors for residual pivot shift after anterior cruciate ligament reconstruction: data from the MAKS group

Authors: Hiroko Ueki, Yusuke Nakagawa, Toshiyuki Ohara, Toshifumi Watanabe, Masafumi Horie, Hiroki Katagiri, Koji Otabe, Kenta Katagiri, Kanehiro Hiyama, Mai Katakura, Takashi Hoshino, Kei Inomata, Naoko Araya, Ichiro Sekiya, Takeshi Muneta, Hideyuki Koga

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 12/2018

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Abstract

Purpose

To investigate the risk factors for residual pivot shift test after anterior cruciate ligament (ACL) reconstruction based on a multicenter prospective cohort study.

Methods

This study included patients who were registered in the Multicenter Arthroscopic Knee Surgery Study, a prospective longitudinal multicenter cohort study, and who underwent primary ACL reconstruction using autologous hamstring tendon graft between 2013 and 2016. The exclusion criteria included prior injuries or surgeries in the contralateral knee, prior ligamentous injuries in the involved knee, grade 2 or 3 concomitant ligament injuries, and inflammatory or other forms of osteoarthritis. Data from the preoperative period and at 1-year follow-up were used for further analysis, and patients with incomplete data, re-injury and loss to follow-up were also excluded. Logistic regression analysis was conducted with age, gender, Lachman test, pivot shift test, KT measurement, hyperextension, single-bundle vs. double-bundle, meniscus injury sites, and meniscus treatments as the independent variables, and postoperative pivot shift test was used as the dependent variable.

Results

Three hundred and sixty-eight patients were included in the study. Hyperextension knee (P = 0.025) and a preoperative pivot shift test under anesthesia (P = 0.040) were identified as risk factors for a postoperative pivot shift via logistic regression analysis. There were no statistically significant differences in the other variables.

Conclusions

The results from a multicenter cohort study indicated that knee hyperextension and greater preoperative pivot shift under anesthesia were risk factors for residual pivot shift at 1 year after ACL reconstruction. In cases with a preoperative high-grade pivot shift and knee hyperextension, additional anterolateral structure augmentation might be considered in order to eliminate pivot shift and eventually obtain better outcomes after ACL reconstruction.

Level of evidence

II.
Literature
1.
Ahn JH, Lee SH (2016) Risk factors for knee instability after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 24:2936–2942CrossRef
2.
Ayeni OR, Chahal M, Tran MN, Sprague S (2012) Pivot shift as an outcome measure for ACL reconstruction: a systematic review. Knee Surg Sports Traumatol Arthrosc 20:767–777CrossRef
3.
Beighton P, Horan F (1969) Orthopaedic aspects of the Ehlers–Danlos syndrome. J Bone Jt Surg Br 51:444–453CrossRef
4.
Benjaminse A, Gokeler A, van der Schans CP (2006) Clinical diagnosis of an anterior cruciate ligament rupture: a meta-analysis. J Orthop Sports Phys Ther 36:267–288CrossRef
5.
Brandon ML, Haynes PT, Bonamo JR, Flynn MI, Barrett GR, Sherman MF (2006) The association between posterior–inferior tibial slope and anterior cruciate ligament insufficiency. Arthroscopy 22:894–899CrossRef
6.
Briggs KK, Kocher MS, Rodkey WG, Steadman JR (2006) Reliability, validity, and responsiveness of the Lysholm knee score and Tegner activity scale for patients with meniscal injury of the knee. J Bone Jt Surg Am 88:698–705
7.
Chahla J, Menge TJ, Mitchell JJ, Dean CS, LaPrade RF (2016) Anterolateral ligament reconstruction technique: an anatomic-based approach. Arthrosc Tech 5:e453–e457CrossRef
8.
Chambat P, Guier C, Sonnery-Cottet B, Fayard JM, Thaunat M (2013) The evolution of ACL reconstruction over the last fifty years. Int Orthop 37:181–186CrossRef
9.
Faul F, Erdfelder E, Buchner A, Lang AG (2009) Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 41:1149–1160CrossRef
10.
Georgoulis AD, Papadonikolakis A, Papageorgiou CD, Mitsou A, Stergiou N (2003) Three-dimensional tibiofemoral kinematics of the anterior cruciate ligament-deficient and reconstructed knee during walking. Am J Sports Med 31:75–79CrossRef
11.
Group M, Wright RW, Huston LJ, Spindler KP, Dunn WR, Haas AK et al (2010) Descriptive epidemiology of the Multicenter ACL Revision Study (MARS) cohort. Am J Sports Med 38:1979–1986CrossRef
12.
Hefti F, Muller W, Jakob RP, Staubli HU (1993) Evaluation of knee ligament injuries with the IKDC form. Knee Surg Sports Traumatol Arthrosc 1:226–234CrossRef
13.
Hettrich CM, Dunn WR, Reinke EK, Spindler KP (2013) The rate of subsequent surgery and predictors after anterior cruciate ligament reconstruction: two- and 6-year follow-up results from a multicenter cohort. Am J Sports Med 41:1534–1540CrossRef
14.
Jagodzinski M, Leis A, Iselborn KW, Mall G, Nerlich M, Bosch U (2003) Impingement pressure and tension forces of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 11:85–90CrossRef
15.
Jonsson H, Riklund-Ahlstrom K, Lind J (2004) Positive pivot shift after ACL reconstruction predicts later osteoarthrosis: 63 patients followed 5–9 years after surgery. Acta Orthop Scand 75:594–599CrossRef
16.
Kim SJ, Moon HK, Kim SG, Chun YM, Oh KS (2010) Does severity or specific joint laxity influence clinical outcomes of anterior cruciate ligament reconstruction? Clin Orthop Relat Res 468:1136–1141CrossRef
17.
Kocher MS, Steadman JR, Briggs KK, Sterett WI, Hawkins RJ (2004) Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction. Am J Sports Med 32:629–634CrossRef
18.
Koga H, Muneta T, Yagishita K, Watanabe T, Mochizuki T, Horie M et al (2014) Effect of femoral tunnel position on graft tension curves and knee stability in anatomic double-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 22:2811–2820CrossRef
19.
Lie DT, Bull AM, Amis AA (2007) Persistence of the mini pivot shift after anatomically placed anterior cruciate ligament reconstruction. Clin Orthop Relat Res 457:203–209PubMed
20.
Magnussen RA, Reinke EK, Huston LJ, Hewett TE, Spindler KP (2016) Factors associated with high-grade Lachman, pivot shift, and anterior drawer at the time of anterior cruciate ligament reconstruction. Arthroscopy 32:1080–1085CrossRef
21.
Minami T, Muneta T, Sekiya I, Watanabe T, Mochizuki T, Horie M et al (2018) Lateral meniscus posterior root tear contributes to anterolateral rotational instability and meniscus extrusion in anterior cruciate ligament-injured patients. Knee Surg Sports Traumatol Arthrosc 26:1174–1181PubMed
22.
Musahl V, Rahnemai-Azar AA, Costello J, Arner JW, Fu FH, Hoshino Y et al (2016) The influence of meniscal and anterolateral capsular injury on knee laxity in patients with anterior cruciate ligament injuries. Am J Sports Med 44:3126–3131CrossRef
23.
Nakamura K, Koga H, Sekiya I, Watanabe T, Mochizuki T, Horie M et al (2017) Evaluation of pivot shift phenomenon while awake and under anaesthesia by different manoeuvres using triaxial accelerometer. Knee Surg Sports Traumatol Arthrosc 25:2377–2383CrossRef
24.
Orchard J, Seward H, McGivern J, Hood S (2001) Intrinsic and extrinsic risk factors for anterior cruciate ligament injury in Australian footballers. Am J Sports Med 29:196–200CrossRef
25.
Ristanis S, Stergiou N, Patras K, Vasiliadis HS, Giakas G, Georgoulis AD (2005) Excessive tibial rotation during high-demand activities is not restored by anterior cruciate ligament reconstruction. Arthroscopy 21:1323–1329CrossRef
26.
Saito K, Hatayama K, Terauchi M, Hagiwara K, Higuchi H, Takagishi K (2015) Clinical outcomes after anatomic double-bundle anterior cruciate ligament reconstruction: comparison of extreme knee hyperextension and normal to mild knee hyperextension. Arthroscopy 31:1310–1317CrossRef
27.
Signorelli C, Bonanzinga T, Lopomo N, Marcheggiani Muccioli GM, Bignozzi S, Filardo G et al (2013) Do pre-operative knee laxity values influence post-operative ones after anterior cruciate ligament reconstruction? Scand J Med Sci Sports 23:e219-224CrossRef
28.
Song GY, Hong L, Zhang H, Zhang J, Li Y, Feng H (2016) Clinical outcomes of combined lateral extra-articular tenodesis and intra-articular anterior cruciate ligament reconstruction in addressing high-grade pivot-shift phenomenon. Arthroscopy 32:898–905CrossRef
29.
Song GY, Zhang H, Wang QQ, Zhang J, Li Y, Feng H (2016) Risk factors associated with grade 3 pivot shift after acute anterior cruciate ligament injuries. Am J Sports Med 44:362–369CrossRef
30.
Sonnery-Cottet B, Saithna A, Cavalier M, Kajetanek C, Temponi EF, Daggett M et al (2017) Anterolateral ligament reconstruction is associated with significantly reduced ACL graft rupture rates at a minimum follow-up of 2 years: a prospective comparative study of 502 patients from the SANTI study group. Am J Sports Med 45:1547–1557CrossRef
31.
Sonnery-Cottet B, Thaunat M, Freychet B, Pupim BH, Murphy CG, Claes S (2015) Outcome of a combined anterior cruciate ligament and anterolateral ligament reconstruction technique with a minimum 2-year follow-up. Am J Sports Med 43:1598–1605CrossRef
32.
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 32:975–983CrossRef
33.
Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49
34.
Vundelinckx B, Herman B, Getgood A, Litchfield R (2017) Surgical indications and technique for anterior cruciate ligament reconstruction combined with lateral extra-articular tenodesis or anterolateral ligament reconstruction. Clin Sports Med 36:135–153CrossRef
35.
Wagih AM, Elguindy AM (2016) Percutaneous reconstruction of the anterolateral ligament of the knee with a polyester tape. Arthrosc Tech 5:691–697CrossRef
Metadata
Title
Risk factors for residual pivot shift after anterior cruciate ligament reconstruction: data from the MAKS group
Authors
Hiroko Ueki
Yusuke Nakagawa
Toshiyuki Ohara
Toshifumi Watanabe
Masafumi Horie
Hiroki Katagiri
Koji Otabe
Kenta Katagiri
Kanehiro Hiyama
Mai Katakura
Takashi Hoshino
Kei Inomata
Naoko Araya
Ichiro Sekiya
Takeshi Muneta
Hideyuki Koga
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 12/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-5005-4

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