Steeper lateral posterior tibial slope and greater lateral-medial slope asymmetry correlate with greater preoperative pivot-shift in anterior cruciate ligament injury.

Autor: Kataoka, Kiminari, Nagai, Kanto, Hoshino, Yuichi, Shimabukuro, Masashi, Nishida, Kyohei, Kanzaki, Noriyuki, Matsushita, Takehiko, Kuroda, Ryosuke
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Zdroj: Journal of Experimental Orthopaedics; 12/7/2022, Vol. 9 Issue 1, p1-7, 7p
Abstrakt: Purpose: To investigate the association between posterior tibial slope (PTS) and preoperative pivot-shift phenomenon in anterior cruciate ligament (ACL)-injured knees. Methods: Fifty unilateral ACL-injured patients (mean age: 28.0 ± 11.4 years, 29 males) who underwent ACL reconstruction were retrospectively included. Patients with a history of injury to the ipsilateral knee joint, concomitant ligament injuries with ACL injury, and/or more than one year from injury to surgery, were excluded. Pivot-shift tests were performed preoperatively under general anaesthesia using an electromagnetic measurement system, and tibial acceleration (m/s2) during the posterior reduction of the tibia was measured. Medial and lateral PTS (°) were measured respectively using high-resolution CT images taken two weeks after surgery. Lateral-medial slope asymmetry was calculated by subtracting medial PTS from lateral PTS (lateral-medial PTS) and we evaluated the correlation between each PTS parameter (medial PTS, lateral PTS, and lateral-medial slope asymmetry) and tibial acceleration during the pivot-shift test. The level of significance was set at p < 0.05. Results: Medial PTS was 4.9 ± 2.0°, and lateral PTS was 5.2 ± 1.9°. The lateral-medial slope asymmetry was 0.3 ± 1.6° (range: -2.9 to 3.8). Tibial acceleration during the pivot-shift test in the ACL-injured knee was 1.6 ± 0.1 m/s2. Preoperative tibial acceleration was positively correlated with lateral PTS (r = 0.436, p < 0.01), and lateral-medial slope asymmetry (r = 0.443, p < 0.01), while no significant correlation was found between preoperative tibial acceleration and medial PTS (r = 0.06, p = 0.70). Conclusion: Preoperative greater tibial acceleration during the pivot-shift test was associated with steeper lateral PTS and greater lateral-medial slope asymmetry in ACL-injured knees. These findings improve our understanding of anterolateral rotatory knee laxity by linking tibial bony morphology to quantitative measurement of pivot-shift phenomenon. Surgeons should be aware that not only lateral PTS but also lateral-medial slope asymmetry are the factors associated with preoperative pivot-shift. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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