Gravity-assisted pivot-shift test for anterior cruciate ligament injury: a new procedure to detect anterolateral rotatory instability of the knee joint
| Autor: | Naoki Kobayashi, Toyohiko Kanda, Koichi Saotome, Hisatada Hiraoka, Hiroya Sakai, Hisataka Yajima, Kazuya Tamai |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Joint Instability Male musculoskeletal diseases medicine.medical_specialty Supine position Adolescent Knee Joint Rotation medicine.medical_treatment Anterior cruciate ligament Arthroscopy Supine Position Humans Medicine Orthopedics and Sports Medicine Anterior Cruciate Ligament Range of Motion Articular Physical Examination Reduction (orthopedic surgery) medicine.diagnostic_test business.industry Anterior Cruciate Ligament Injuries Pivot-shift test Middle Aged musculoskeletal system medicine.disease ACL injury Surgery medicine.anatomical_structure Orthopedic surgery Female business human activities |
| Zdroj: | Knee Surgery, Sports Traumatology, Arthroscopy. 14:2-6 |
| ISSN: | 1433-7347 0942-2056 |
| Popis: | The denominated gravity-assisted pivot-shift test was introduced as a new procedure to detect anterolateral rotatory instability of the knee joint. The patient lies in the supine position or slightly rotated onto the affected side. The affected knee flexed approximately 60 degrees and the ipsilateral hip flexed, abducted and externally rotated so that the plane of the knee motion runs parallel to the floor. The examiner instructs the patient to raise the affected leg off the examining table and to extend the affected knee gradually. If the lower leg is internally rotated suddenly, with the knee subluxated at an angle of approximately 20 degrees , followed by the reduction in flexion, this test is regarded as positive. This test was investigated on 51 anterior cruciate ligament (ACL) deficient knees, being positive in 30 knees (Group P) and negative in 21 (Group N) with the positive rate of 59%. There was no significant correlation between the result of this test and the clinical features, but Group N included relatively small number of females and recurrent injuries tended to occur more frequently in Group P. Thirty-six knees received ACL reconstruction subsequently. There was no statistically significant difference between the groups in the side-to-side difference in anterior knee laxity at one year postoperatively. However, three patients with the side-to side difference of more than 3 mm belonged to Group P. Relatively low positive rate in ACL deficient knees suggests that it may not be used as a diagnostic procedure for ACL injury. It is possibly used for the prediction of high risk patients for symptomatic giving-way and/or patients with poor prognosis after ACL reconstruction. |
| Databáze: | OpenAIRE |
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