Details

Autor(en) / Beteiligte

• Vind, Tobias Dahl
• Petersen, Emil Toft
• Sørensen, Ole Gade
• Lindgren, Lars
• Stilling, Maiken

Titel

Dynamic radiostereometry can objectively quantify the kinematic laxity patterns and rotation instability of the knee during a pivot‐shift test

Ist Teil von

• Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2024-06, Vol.32 (6), p.1492-1506

Ort / Verlag

Germany

Erscheinungsjahr

2024

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Purpose The pivot‐shift test is used to clinically assess knee instability in patients with anterior cruciate ligament (ACL) lesions; however, it has low interobserver reliability. Dynamic radiostereometry (dRSA) is a highly precise and noninvasive method for the objective evaluation of joint kinematics. The purpose of this study was to quantify precise knee kinematics during a pivot‐shift test using dRSA imaging. Method Eight human donor legs, including hemipelvises, were evaluated. Arthroscopic intervention was performed inducing ligament lesions in the ACL, and anterolateral ligament (ALL) section was performed as a capsular incision. The pivot‐shift test was recorded with dRSA on knees with intact ligaments, ACL‐deficient and ACL + ALL‐deficient knees. Results A pivot‐shift pattern was identifiable after ligament lesion, as a change in tibial posterior drawer velocity from 7.8 mm/s (95% CI: 3.7; 11.9) in ligament intact knees to 30.4 mm/s (95% CI 23.0; 38.8) after ACL lesion to 35.1 mm/s (95% CI 23.4; 46.7) after combined ACL‐ALL lesion. The anterior‐posterior drawer excursion increased from 2.8 mm (95% CI 2.1; 3.4) in ligament intact knees to 7.2 mm (95% CI 5.5; 8.9) after ACL lesion to 7.6 mm (95% CI 5.5; 9.8) after combined lesion. A statistically significant increase in tibial external rotation towards the end of the pivot‐shift motion was observed when progressing from intact to ACL + ALL‐deficient knees (p < 0.023). Conclusion This experimental study demonstrates the feasibility of dRSA to objectively quantify the kinematic laxity patterns of the knee during the pivot‐shift test. The dynamic parameters obtained through dRSA revealed the kinematic changes from ACL to combined ACL‐ALL ligament lesion. Level of Evidence Not applicable. The pivot‐shift test is used for clinical grading of rotational knee instability following anterior cruciate ligament (ACL) lesion but has great observer variability. Dynamic radiostereometry is a highly precise imaging method for the evaluation of joint kinematics and this experimental study proved feasible for objective quantification of the pivot‐shift following isolated ACL lesions and in combination with anterolateral ligament (ALL) lesion.