Risk factors for residual anterolateral rotational instability after double bundle anterior cruciate ligament reconstruction: Evaluation by quantitative assessment of the pivot shift phenomenon using triaxial accelerometer.
Acceleration
Accelerometry
Adult
Anterior Cruciate Ligament Injuries
/ complications
Anterior Cruciate Ligament Reconstruction
/ adverse effects
Disease Progression
Female
Humans
Joint Instability
/ etiology
Knee Joint
Male
Middle Aged
Postoperative Complications
/ etiology
Range of Motion, Articular
Risk Factors
Tibia
Young Adult
Anterior cruciate ligament
Anterolateral rotational instability
Pivot shift test
Triaxial accelerometer
Journal
The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
06
06
2019
revised:
18
08
2019
accepted:
27
09
2019
pubmed:
2
11
2019
medline:
8
9
2020
entrez:
2
11
2019
Statut:
ppublish
Résumé
Exact knowledge of risk factors for residual anterolateral rotatinoal instability (ALRI) after anterior cruciate ligament (ACL) reconstruction is limited. The purpose of this study was to analyse possible risk factors for ALRI after ACL reconstruction. Quantitative assessment of the pivot shift phenomenon by measuring tibial acceleration was performed in 46 patients during primary double-bundle ACL reconstructions. The absolute value of the acceleration of the injured knee after provisional fixation of the ACL grafts ('absolute residual acceleration') and the subtraction of the acceleration of the uninjured knee from absolute residual acceleration ('relative residual acceleration') were defined as indicators for residual ALRI. The associations between these indicators and nine candidate risk factors were analysed using univariate and multiple regression analyses. Multiple regression analysis revealed that absolute residual acceleration was positively associated with both preoperative acceleration difference between injured and uninjured knees (β = 0.469, P < 0.001) and tibial acceleration of the uninjured knee (β = 0.597, P < 0.001). Relative residual acceleration was also positively associated with preoperative acceleration difference between injured and uninjured knees (β = 0.446, P< 0.001), but was negatively associated with tibial acceleration of the uninjured knee (β = -0.763, P < 0.001). Patients with larger preoperative side-to-side difference of the pivot shift phenomenon have higher risk for both absolute and relative residual ALRIs after ACL reconstruction, whereas patients with larger pivot shift phenomenon in their uninjured knees are at higher risk for absolute residual ALRI but not for relative residual ALRI.
Sections du résumé
BACKGROUND
BACKGROUND
Exact knowledge of risk factors for residual anterolateral rotatinoal instability (ALRI) after anterior cruciate ligament (ACL) reconstruction is limited. The purpose of this study was to analyse possible risk factors for ALRI after ACL reconstruction.
METHODS
METHODS
Quantitative assessment of the pivot shift phenomenon by measuring tibial acceleration was performed in 46 patients during primary double-bundle ACL reconstructions. The absolute value of the acceleration of the injured knee after provisional fixation of the ACL grafts ('absolute residual acceleration') and the subtraction of the acceleration of the uninjured knee from absolute residual acceleration ('relative residual acceleration') were defined as indicators for residual ALRI. The associations between these indicators and nine candidate risk factors were analysed using univariate and multiple regression analyses.
RESULTS
RESULTS
Multiple regression analysis revealed that absolute residual acceleration was positively associated with both preoperative acceleration difference between injured and uninjured knees (β = 0.469, P < 0.001) and tibial acceleration of the uninjured knee (β = 0.597, P < 0.001). Relative residual acceleration was also positively associated with preoperative acceleration difference between injured and uninjured knees (β = 0.446, P< 0.001), but was negatively associated with tibial acceleration of the uninjured knee (β = -0.763, P < 0.001).
CONCLUSIONS
CONCLUSIONS
Patients with larger preoperative side-to-side difference of the pivot shift phenomenon have higher risk for both absolute and relative residual ALRIs after ACL reconstruction, whereas patients with larger pivot shift phenomenon in their uninjured knees are at higher risk for absolute residual ALRI but not for relative residual ALRI.
Identifiants
pubmed: 31672497
pii: S0968-0160(19)30225-X
doi: 10.1016/j.knee.2019.09.016
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
95-101Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors confirm that there are no known conflicts of interest associated with this publication and this research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.