Article

Assessment of anterolateral rotatory instability in the anterior cruciate ligament-deficient knee using an open magnetic resonance imaging system.

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
The American Journal of Sports Medicine (impact factor: 3.79). 08/2007; 35(7):1091-7. DOI:10.1177/0363546507299530 pp.1091-7
Source: PubMed

ABSTRACT In the clinical evaluation of the anterior cruciate ligament-deficient knee, anterolateral rotatory instability is assessed by manual tests such as the pivot-shift test, which is subjective and not quantitative.
The anterolateral rotatory instability in an anterior cruciate ligament-deficient knee can be quantified by our newly developed method using open magnetic resonance imaging.
Controlled laboratory study.
Eighteen subjects with anterior cruciate ligament-deficient knees and 18 with normal knees were recruited. We administered the Slocum anterolateral rotatory instability test in the open magnetic resonance imaging scanner and scanned the sagittal view of the knee. The anterior displacements of the tibia at the medial and lateral compartments were measured. Furthermore, we examined 14 anterior cruciate ligament-deficient knees twice to assess intraobserver and interobserver reproducibility and evaluated the difference and interclass correlation coefficient of 2 measures.
In the anterior cruciate ligament-deficient knee, displacement was 14.4 +/- 5.5 mm at the lateral compartment and 1.6 +/- 2.3 mm at the medial compartment; in the normal knee, displacement was 0.7 +/- 1.9 mm and -1.1 +/- 1.2 mm, respectively. The difference and interclass correlation coefficient between 2 repeated measures at the lateral compartment were 1.0 +/- 0.7 mm and .98 for intraobserver reproducibility and 1.1 +/- 0.7 mm and .91 for interobserver reproducibility.
This method is useful to assess the anterolateral rotatory instability of the anterior cruciate ligament-deficient knee.
This method can be used in the clinical assessment of anterior cruciate ligament stability, such as comparing studies of graft positions or 2-bundle anatomic reconstruction and the conventional 1-bundle technique.

0 0
 · 
0 Bookmarks
 · 
33 Views
  • Source
    Article: Comparison between clinical grading and navigation data of knee laxity in ACL-deficient knees.
    Yuji Yamamoto, Yasuyuki Ishibashi, Eiichi Tsuda, Harehiko Tsukada, Shugo Maeda, Satoshi Toh
    [show abstract] [hide abstract]
    ABSTRACT: The latest version of the navigation system for anterior cruciate ligament (ACL) reconstruction has the supplementary ability to assess knee stability before and after ACL reconstruction. In this study, we compared navigation data between clinical grades in ACL-deficient knees and also analyzed correlation between clinical grading and navigation data. 150 ACL deficient knees that received primary ACL reconstruction using an image-free navigation system were included. For clinical evaluation, the Lachman, anterior drawer, and pivot shift tests were performed under general anesthesia and were graded by an examiner. For the assessment of knee stability using the navigation system, manual tests were performed again before ACL reconstruction. Navigation data were recorded as anteroposterior (AP) displacement of the tibia for the Lachman and anterior drawer tests, and both AP displacement and tibial rotation for the pivot shift test. Navigation data of each clinical grade were as follows; Lachman test grade 1+: 10.0 mm, grade 2+: 13.2 ± 3.1 mm, grade 3+: 14.5 ± 3.3 mm, anterior drawer test grade 1+: 6.8 ± 1.4 mm, grade 2+: 7.4 ± 1.8 mm, grade 3+: 9.1 ± 2.3 mm, pivot shift test grade 1+: 3.9 ± 1.8 mm/21.5° ± 7.8°, grade 2+: 4.8 ± 2.1 mm/21.8° ± 7.1°, and grade 3+: 6.0 ± 3.2 mm/21.1° ± 7.1°. There were positive correlations between clinical grading and AP displacement in the Lachman, and anterior drawer tests. Although positive correlations between clinical grading and AP displacement in pivot shift test were found, there were no correlations between clinical grading and tibial rotation in pivot shift test. In response to AP force, the navigation system can provide the surgeon with correct objective data for knee laxity in ACL deficient knees. During the pivot shift test, physicians may grade according to the displacement of the tibia, rather than rotation.
    Sports Medicine Arthroscopy Rehabilitation Therapy & Technology 11/2010; 2:27.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

14 anterior cruciate ligament-deficient knees
 
2-bundle anatomic reconstruction
 
anterior cruciate ligament stability
 
anterior cruciate ligament-deficient knee
 
anterior cruciate ligament-deficient knees
 
anterolateral rotatory instability
 
clinical evaluation
 
comparing studies
 
Controlled laboratory study
 
conventional 1-bundle technique
 
interclass correlation coefficient
 
interobserver reproducibility
 
lateral compartment
 
manual tests
 
normal knee
 
open magnetic resonance imaging
 
open magnetic resonance imaging scanner
 
pivot-shift test
 
sagittal view
 
Slocum anterolateral rotatory instability test