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7. Individualized ACL reconstruction

Author

Araujo, Paulo H., Kfuri Junior, Mauricio, Ohashi, Bruno, Hoshino, Yuichi, Zaffagnini, Stephano, Samuelsson, Kristian, Karlsson, Jon, Fu, Freddie, and Musahl, Volker

Published
2014
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18. Individualized ACL reconstruction

Author

Stephano Zaffagnini, Freddie H. Fu, Volker Musahl, Paulo Henrique Cavalcanti de Araújo, Yuichi Hoshino, Jon Karlsson, Bruno Ohashi, Kristian Samuelsson, Mauricio Kfuri Junior, Araujo, Paulo H., Kfuri Junior, Mauricio, Ohashi, Bruno, Hoshino, Yuichi, Zaffagnini, Stefano, Samuelsson, Kristian, Karlsson, Jon, Fu, Freddie, and Musahl, Volker

Subjects
Joint Instability, medicine.medical_specialty, Knee Joint, Rotation, Anterior cruciate ligament, Pivot shift, Predictive Value of Test, Knee Injuries, Surgical planning, Physical medicine and rehabilitation, Predictive Value of Tests, Image Processing, Computer-Assisted, medicine, Humans, Orthopedics and Sports Medicine, Diagnosis, Computer-Assisted, Anterior Cruciate Ligament, Range of Motion, Articular, Physical Examination, Knee Injurie, Anterior Cruciate Ligament Reconstruction, business.industry, Medicine (all), Anterior Cruciate Ligament Injuries, Pivot-shift test, Osteoarthritis, Knee, musculoskeletal system, medicine.disease, ACL injury, Biomechanical Phenomena, Algorithm, medicine.anatomical_structure, Knee laxity, Orthopedic surgery, Physical therapy, PROCEDIMENTOS CIRÚRGICOS RECONSTRUTIVOS, Surgery, business, Range of motion, human activities, Algorithms, Human
Abstract

The pivot shift test is the only physical examination test capable of predicting knee function and osteoarthritis development after an ACL injury. However, because interpretation and performance of the pivot shift are subjective in nature, the validity of the pivot shift is criticized for not providing objective information for a complete surgical planning for the treatment of rotatory knee laxity. The aim of ACL reconstruction was eliminating the pivot shift sign. Many structures and anatomical characteristics can influence the grading of the pivot shift test and are involved in the genesis and magnitude of rotatory instability after an ACL injury. The objective quantification of the pivot shift may be able to categorize knee laxity and provide adequate information on which structures are affected besides the ACL. A new algorithm for rotational instability treatment is presented, accounting for patients’ unique anatomical characteristics and objective measurement of the pivot shift sign allowing for an individualized surgical treatment. Level of evidence V.

Published
2014

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