Increased lateral tibial slope predicts high-grade rotatory knee laxity pre-operatively in ACL reconstruction
Purpose To determine the influence of anatomical features of both the tibia and femur on quantitative pivot shift of anterior cruciate ligament (ACL)-injured patients. Methods Fifty-three consecutive ACL-injured patients (mean age 26 ± 10.1 years, 36 males) who underwent ACL reconstruction were pros...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2017-04, Vol.25 (4), p.1170-1176 |
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| creator | Rahnemai-Azar, Ata A. Abebe, Ermias S. Johnson, Paul Labrum, Joseph Fu, Freddie H. Irrgang, James J. Samuelsson, Kristian Musahl, Volker |
| description | Purpose
To determine the influence of anatomical features of both the tibia and femur on quantitative pivot shift of anterior cruciate ligament (ACL)-injured patients.
Methods
Fifty-three consecutive ACL-injured patients (mean age 26 ± 10.1 years, 36 males) who underwent ACL reconstruction were prospectively enrolled. Two blinded observers measured the parameters of medial and lateral tibial slope, femoral condyle width, notch width, bicondylar width and tibial plateau width on magnetic resonance imaging. The same examiner performed pivot shift under anaesthesia, while a previously validated image analysis technique was used to quantify knee kinematics during examination. The median lateral compartment translation detected during pivot shift testing (2.8 mm) was used to classify patients into “low-grade rotatory laxity” (≤2.8 mm) and “high-grade rotatory laxity” (>2.8 mm) groups.
Results
Twenty-nine subjects were grouped as “low-grade rotatory laxity”, and 24 subjects were grouped as “high-grade rotatory laxity”. Of the tested bone morphologic parameters, lateral tibial plateau slope was significantly greater in “high-grade rotatory laxity” group (9.3° ± 3.4°) compared to “low-grade rotatory laxity” group (6.1° ± 3.7°) (
p
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| doi_str_mv | 10.1007/s00167-016-4157-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1826680064</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1899610798</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-f6f18eedf7e9063a50728568c346156bec2cb187a9edb87c92725ca5bb8efe053</originalsourceid><addsrcrecordid>eNp1kU9vEzEQxS1UREPhA3CpLPXCxWB7_fdYRS1UisQFzpbXO5u6bNap7a3It8dRCkKVuMyM5N97Y81D6AOjnxil-nOhlClNWiGCSU26V2jFRNcR3Ql9hlbUCk44leocvS3lgdI2CvsGnXPNpODartDubg4ZfIEBT75C9hOusY-tlSntAe8zDDHUgu_j9p5ssx8A51R9TfmAf84ATfYr1sMRJE2QfY1PMB1wnPH1eoMzhDSXmpdQY5rfodejnwq8f-4X6Mftzff1V7L59uVufb0hQQheyahGZgCGUYOlqvOSam6kMqETiknVQ-ChZ0Z7C0NvdLBccxm87HsDI1DZXaCPJ999To8LlOp2sQSYJj9DWopjhitlKFWioVcv0Ie05Ln9rlHWKka1NY1iJyrkVEqG0e1z3Pl8cIy6YxbulIVrxR2zcF3TXD47L_0Ohr-KP8dvAD8BpT3NW8j_rP6v628vnZWH</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1899610798</pqid></control><display><type>article</type><title>Increased lateral tibial slope predicts high-grade rotatory knee laxity pre-operatively in ACL reconstruction</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Rahnemai-Azar, Ata A. ; Abebe, Ermias S. ; Johnson, Paul ; Labrum, Joseph ; Fu, Freddie H. ; Irrgang, James J. ; Samuelsson, Kristian ; Musahl, Volker</creator><creatorcontrib>Rahnemai-Azar, Ata A. ; Abebe, Ermias S. ; Johnson, Paul ; Labrum, Joseph ; Fu, Freddie H. ; Irrgang, James J. ; Samuelsson, Kristian ; Musahl, Volker</creatorcontrib><description>Purpose
To determine the influence of anatomical features of both the tibia and femur on quantitative pivot shift of anterior cruciate ligament (ACL)-injured patients.
Methods
Fifty-three consecutive ACL-injured patients (mean age 26 ± 10.1 years, 36 males) who underwent ACL reconstruction were prospectively enrolled. Two blinded observers measured the parameters of medial and lateral tibial slope, femoral condyle width, notch width, bicondylar width and tibial plateau width on magnetic resonance imaging. The same examiner performed pivot shift under anaesthesia, while a previously validated image analysis technique was used to quantify knee kinematics during examination. The median lateral compartment translation detected during pivot shift testing (2.8 mm) was used to classify patients into “low-grade rotatory laxity” (≤2.8 mm) and “high-grade rotatory laxity” (>2.8 mm) groups.
Results
Twenty-nine subjects were grouped as “low-grade rotatory laxity”, and 24 subjects were grouped as “high-grade rotatory laxity”. Of the tested bone morphologic parameters, lateral tibial plateau slope was significantly greater in “high-grade rotatory laxity” group (9.3° ± 3.4°) compared to “low-grade rotatory laxity” group (6.1° ± 3.7°) (
p
< 0.05). Lateral tibial plateau slope was a significant predictor of “high-grade rotatory laxity” (odds ratio 1.27,
p
< 0.05). A tibial slope of 9° and greater predicted “high-grade rotatory laxity” (sensitivity 63 %; specificity 72 %).
Conclusion
Increased slope of the lateral tibial plateau might be an important anatomical variable predicting high-grade rotatory laxity in patients with ACL injury. The finding can be useful in the clinical setting in predicting potential non-copers to conservative therapy and aid in the individualization of the reconstructive procedures of patients.
Level of evidence
Prospective diagnostic study, Level II.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-016-4157-3</identifier><identifier>PMID: 27154279</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Anesthesia ; Anterior cruciate ligament ; Anterior Cruciate Ligament Injuries - physiopathology ; Anterior Cruciate Ligament Reconstruction ; Diagnostic systems ; Female ; Femur ; Humans ; Image analysis ; Image processing ; Injuries ; Joint Instability - diagnosis ; Joint Instability - physiopathology ; Kinematics ; Knee ; Knee Joint - diagnostic imaging ; Knee Joint - physiopathology ; Ligaments ; Magnetic Resonance Imaging ; Male ; Males ; Medicine ; Medicine & Public Health ; Orthopedics ; Patients ; Preoperative Period ; Prospective Studies ; Quality ; Rotation ; Skin & tissue grafts ; Slopes ; Tibia</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017-04, Vol.25 (4), p.1170-1176</ispartof><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2016</rights><rights>Knee Surgery, Sports Traumatology, Arthroscopy is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-f6f18eedf7e9063a50728568c346156bec2cb187a9edb87c92725ca5bb8efe053</citedby><cites>FETCH-LOGICAL-c442t-f6f18eedf7e9063a50728568c346156bec2cb187a9edb87c92725ca5bb8efe053</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-016-4157-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-016-4157-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27154279$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rahnemai-Azar, Ata A.</creatorcontrib><creatorcontrib>Abebe, Ermias S.</creatorcontrib><creatorcontrib>Johnson, Paul</creatorcontrib><creatorcontrib>Labrum, Joseph</creatorcontrib><creatorcontrib>Fu, Freddie H.</creatorcontrib><creatorcontrib>Irrgang, James J.</creatorcontrib><creatorcontrib>Samuelsson, Kristian</creatorcontrib><creatorcontrib>Musahl, Volker</creatorcontrib><title>Increased lateral tibial slope predicts high-grade rotatory knee laxity pre-operatively in ACL reconstruction</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
To determine the influence of anatomical features of both the tibia and femur on quantitative pivot shift of anterior cruciate ligament (ACL)-injured patients.
Methods
Fifty-three consecutive ACL-injured patients (mean age 26 ± 10.1 years, 36 males) who underwent ACL reconstruction were prospectively enrolled. Two blinded observers measured the parameters of medial and lateral tibial slope, femoral condyle width, notch width, bicondylar width and tibial plateau width on magnetic resonance imaging. The same examiner performed pivot shift under anaesthesia, while a previously validated image analysis technique was used to quantify knee kinematics during examination. The median lateral compartment translation detected during pivot shift testing (2.8 mm) was used to classify patients into “low-grade rotatory laxity” (≤2.8 mm) and “high-grade rotatory laxity” (>2.8 mm) groups.
Results
Twenty-nine subjects were grouped as “low-grade rotatory laxity”, and 24 subjects were grouped as “high-grade rotatory laxity”. Of the tested bone morphologic parameters, lateral tibial plateau slope was significantly greater in “high-grade rotatory laxity” group (9.3° ± 3.4°) compared to “low-grade rotatory laxity” group (6.1° ± 3.7°) (
p
< 0.05). Lateral tibial plateau slope was a significant predictor of “high-grade rotatory laxity” (odds ratio 1.27,
p
< 0.05). A tibial slope of 9° and greater predicted “high-grade rotatory laxity” (sensitivity 63 %; specificity 72 %).
Conclusion
Increased slope of the lateral tibial plateau might be an important anatomical variable predicting high-grade rotatory laxity in patients with ACL injury. The finding can be useful in the clinical setting in predicting potential non-copers to conservative therapy and aid in the individualization of the reconstructive procedures of patients.
Level of evidence
Prospective diagnostic study, Level II.</description><subject>Adult</subject><subject>Anesthesia</subject><subject>Anterior cruciate ligament</subject><subject>Anterior Cruciate Ligament Injuries - physiopathology</subject><subject>Anterior Cruciate Ligament Reconstruction</subject><subject>Diagnostic systems</subject><subject>Female</subject><subject>Femur</subject><subject>Humans</subject><subject>Image analysis</subject><subject>Image processing</subject><subject>Injuries</subject><subject>Joint Instability - diagnosis</subject><subject>Joint Instability - physiopathology</subject><subject>Kinematics</subject><subject>Knee</subject><subject>Knee Joint - diagnostic imaging</subject><subject>Knee Joint - physiopathology</subject><subject>Ligaments</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Males</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Patients</subject><subject>Preoperative Period</subject><subject>Prospective Studies</subject><subject>Quality</subject><subject>Rotation</subject><subject>Skin & tissue grafts</subject><subject>Slopes</subject><subject>Tibia</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU9vEzEQxS1UREPhA3CpLPXCxWB7_fdYRS1UisQFzpbXO5u6bNap7a3It8dRCkKVuMyM5N97Y81D6AOjnxil-nOhlClNWiGCSU26V2jFRNcR3Ql9hlbUCk44leocvS3lgdI2CvsGnXPNpODartDubg4ZfIEBT75C9hOusY-tlSntAe8zDDHUgu_j9p5ssx8A51R9TfmAf84ATfYr1sMRJE2QfY1PMB1wnPH1eoMzhDSXmpdQY5rfodejnwq8f-4X6Mftzff1V7L59uVufb0hQQheyahGZgCGUYOlqvOSam6kMqETiknVQ-ChZ0Z7C0NvdLBccxm87HsDI1DZXaCPJ999To8LlOp2sQSYJj9DWopjhitlKFWioVcv0Ie05Ln9rlHWKka1NY1iJyrkVEqG0e1z3Pl8cIy6YxbulIVrxR2zcF3TXD47L_0Ohr-KP8dvAD8BpT3NW8j_rP6v628vnZWH</recordid><startdate>20170401</startdate><enddate>20170401</enddate><creator>Rahnemai-Azar, Ata A.</creator><creator>Abebe, Ermias S.</creator><creator>Johnson, Paul</creator><creator>Labrum, Joseph</creator><creator>Fu, Freddie H.</creator><creator>Irrgang, James J.</creator><creator>Samuelsson, Kristian</creator><creator>Musahl, Volker</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20170401</creationdate><title>Increased lateral tibial slope predicts high-grade rotatory knee laxity pre-operatively in ACL reconstruction</title><author>Rahnemai-Azar, Ata A. ; Abebe, Ermias S. ; Johnson, Paul ; Labrum, Joseph ; Fu, Freddie H. ; Irrgang, James J. ; Samuelsson, Kristian ; Musahl, Volker</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-f6f18eedf7e9063a50728568c346156bec2cb187a9edb87c92725ca5bb8efe053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Anesthesia</topic><topic>Anterior cruciate ligament</topic><topic>Anterior Cruciate Ligament Injuries - physiopathology</topic><topic>Anterior Cruciate Ligament Reconstruction</topic><topic>Diagnostic systems</topic><topic>Female</topic><topic>Femur</topic><topic>Humans</topic><topic>Image analysis</topic><topic>Image processing</topic><topic>Injuries</topic><topic>Joint Instability - diagnosis</topic><topic>Joint Instability - physiopathology</topic><topic>Kinematics</topic><topic>Knee</topic><topic>Knee Joint - diagnostic imaging</topic><topic>Knee Joint - physiopathology</topic><topic>Ligaments</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Males</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Patients</topic><topic>Preoperative Period</topic><topic>Prospective Studies</topic><topic>Quality</topic><topic>Rotation</topic><topic>Skin & tissue grafts</topic><topic>Slopes</topic><topic>Tibia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rahnemai-Azar, Ata A.</creatorcontrib><creatorcontrib>Abebe, Ermias S.</creatorcontrib><creatorcontrib>Johnson, Paul</creatorcontrib><creatorcontrib>Labrum, Joseph</creatorcontrib><creatorcontrib>Fu, Freddie H.</creatorcontrib><creatorcontrib>Irrgang, James J.</creatorcontrib><creatorcontrib>Samuelsson, Kristian</creatorcontrib><creatorcontrib>Musahl, Volker</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rahnemai-Azar, Ata A.</au><au>Abebe, Ermias S.</au><au>Johnson, Paul</au><au>Labrum, Joseph</au><au>Fu, Freddie H.</au><au>Irrgang, James J.</au><au>Samuelsson, Kristian</au><au>Musahl, Volker</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased lateral tibial slope predicts high-grade rotatory knee laxity pre-operatively in ACL reconstruction</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2017-04-01</date><risdate>2017</risdate><volume>25</volume><issue>4</issue><spage>1170</spage><epage>1176</epage><pages>1170-1176</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
To determine the influence of anatomical features of both the tibia and femur on quantitative pivot shift of anterior cruciate ligament (ACL)-injured patients.
Methods
Fifty-three consecutive ACL-injured patients (mean age 26 ± 10.1 years, 36 males) who underwent ACL reconstruction were prospectively enrolled. Two blinded observers measured the parameters of medial and lateral tibial slope, femoral condyle width, notch width, bicondylar width and tibial plateau width on magnetic resonance imaging. The same examiner performed pivot shift under anaesthesia, while a previously validated image analysis technique was used to quantify knee kinematics during examination. The median lateral compartment translation detected during pivot shift testing (2.8 mm) was used to classify patients into “low-grade rotatory laxity” (≤2.8 mm) and “high-grade rotatory laxity” (>2.8 mm) groups.
Results
Twenty-nine subjects were grouped as “low-grade rotatory laxity”, and 24 subjects were grouped as “high-grade rotatory laxity”. Of the tested bone morphologic parameters, lateral tibial plateau slope was significantly greater in “high-grade rotatory laxity” group (9.3° ± 3.4°) compared to “low-grade rotatory laxity” group (6.1° ± 3.7°) (
p
< 0.05). Lateral tibial plateau slope was a significant predictor of “high-grade rotatory laxity” (odds ratio 1.27,
p
< 0.05). A tibial slope of 9° and greater predicted “high-grade rotatory laxity” (sensitivity 63 %; specificity 72 %).
Conclusion
Increased slope of the lateral tibial plateau might be an important anatomical variable predicting high-grade rotatory laxity in patients with ACL injury. The finding can be useful in the clinical setting in predicting potential non-copers to conservative therapy and aid in the individualization of the reconstructive procedures of patients.
Level of evidence
Prospective diagnostic study, Level II.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27154279</pmid><doi>10.1007/s00167-016-4157-3</doi><tpages>7</tpages></addata></record> |
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| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017-04, Vol.25 (4), p.1170-1176 |
| issn | 0942-2056 1433-7347 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Anesthesia Anterior cruciate ligament Anterior Cruciate Ligament Injuries - physiopathology Anterior Cruciate Ligament Reconstruction Diagnostic systems Female Femur Humans Image analysis Image processing Injuries Joint Instability - diagnosis Joint Instability - physiopathology Kinematics Knee Knee Joint - diagnostic imaging Knee Joint - physiopathology Ligaments Magnetic Resonance Imaging Male Males Medicine Medicine & Public Health Orthopedics Patients Preoperative Period Prospective Studies Quality Rotation Skin & tissue grafts Slopes Tibia |
| title | Increased lateral tibial slope predicts high-grade rotatory knee laxity pre-operatively in ACL reconstruction |
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