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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 2/2020

01-02-2020 | Magnetic Resonance Imaging | KNEE

No difference in postoperative rotational laxity after ACL reconstruction in patients with and without anterolateral capsule injury: quantitative evaluation of the pivot-shift test at 1-year follow-up

Authors: Yuji Hiroshima, Yuichi Hoshino, Nobuaki Miyaji, Toshikazu Tanaka, Daisuke Araki, Noriyuki Kanzaki, Takehiko Matsushita, Ryosuke Kuroda

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2020

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Abstract

Purpose

To compare rotational laxity in anterior cruciate ligament (ACL)-reconstructed knees retrospectively with and without concomitant anterolateral capsule (ALC) injury confirmed by magnetic resonance imaging (MRI) prior to ACL reconstruction.

Methods

Sixty-two ACL-reconstructed knees (26 men, 36 women; median age 20 (range 13–59)) were included. Pivot-shift test was performed before ACL reconstruction and 1 year postoperatively under anesthesia with both clinical grading and quantitative measurement simultaneously. Clinical grading was determined according to the International Knee Documentation Committee (IKDC) criteria (none, glide, clunk, or gross), and an electromagnetic measurement system was used to provide tibial acceleration as a quantitative parameter. The resence of concomitant ALC injury was confirmed retrospectively by MRI. The pivot-shift test was compared between ACL-reconstructed knees with and without ALC injury test for clinical grading and the independent t test for quantitative evaluation.

Results

ALC injury was identified in 26 of 62 (42%) knees. Before ACL reconstruction, there was no difference in the pivot-shift test results between the ACL-deficient knees with and without ALC injury in IKDC grading (n.s.) or tibial acceleration (1.1 ± 0.7 m/s2 and 1.4 ± 1.1 m/s2, respectively, n.s.). At 1 year postoperatively, no difference was observed between groups (IKDC, p = 0.90; tibial acceleration, 0.6 ± 0.3 m/s2 and 0.8 ± 0.6 m/s2, n.s.).

Conclusions

Concomitant ALC injury at the time of ACL injury had no effect on the rotational laxity of the knee in the postoperative course after ACL reconstruction. Therefore, additional treatment for ALC injury may not be warranted.

Level of evidence

IV.
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Metadata
Title
No difference in postoperative rotational laxity after ACL reconstruction in patients with and without anterolateral capsule injury: quantitative evaluation of the pivot-shift test at 1-year follow-up
Authors
Yuji Hiroshima
Yuichi Hoshino
Nobuaki Miyaji
Toshikazu Tanaka
Daisuke Araki
Noriyuki Kanzaki
Takehiko Matsushita
Ryosuke Kuroda
Publication date
01-02-2020
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2020
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-019-05664-3

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