The Lateral Femoral Notch Sign Is Correlated With Increased Rotatory Laxity After Anterior Cruciate Ligament Injury: Pivot Shift Quantification With A Surgical Navigation System
| Autor: | Gian Andrea Lucidi, Maria Pia Neri, Stefano Di Paolo, Piero Agostinone, Luca Macchiarola, Giacomo Dal Fabbro, Alberto Grassi, Stefano Zaffagnini |
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| Přispěvatelé: | Lucidi G.A., Grassi A., Di Paolo S., Agostinone P., Neri M.P., Macchiarola L., Dal Fabbro G., Zaffagnini S. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Joint Instability
Knee Joint Rotation Anterior cruciate ligament Pivot shift Physical Therapy Sports Therapy and Rehabilitation lateral notch sign 03 medical and health sciences 0302 clinical medicine Humans Medicine Orthopedics and Sports Medicine 030222 orthopedics anterior cruciate injury business.industry Anterior Cruciate Ligament Injuries ACL 030229 sport sciences Anatomy Surgical Navigation Systems Cross-Sectional Studies medicine.anatomical_structure Lateral femoral condyle rotatory laxity business Sign (mathematics) MRI pivot shift |
| Popis: | Background:The lateral femoral notch sign (LNS) is a bony impression on the lateral femoral condyle correlated with anterior cruciate ligament (ACL) injury. Its presence is associated with lateral meniscal injury and higher cartilage degradation on the lateral femoral condyle.Purpose/Hypothesis:The purpose was to investigate the effect of the presence and magnitude of LNS on rotatory instability. The hypothesis was that a positive LNS is correlated with a high-grade pivot shift (PS).Study Design:Cross-sectional study; Level of evidence, 3.Methods:A total of 90 consecutive patients with complete ACL tears between 2013 and 2017 underwent intraoperative kinematic evaluation with the surgical navigation system and were included in the present study. The same surgeon performed a standardized PS under anesthesia. The PS was quantified through the acceleration of the lateral compartment during tibial reduction (PS ACC) and the internal-external rotation (PS IE). Presence and depth of LNS were evaluated on sagittal magnetic resonance images (1.5-T).Results:In 47 patients, the LNS was absent; in 33, the LNS depth was between 1 mm and 2 mm; and in 10 patients, it was deeper than 2 mm. Patients with a notch deeper than 2 mm showed increased PS ACC and PS IE compared with the group without the LNS. However, no significant differences were present between the group with a notch between 1 and 2 mm and the patients without LNS. Receiver operating characteristic curve analysis showed that 2 mm was the most predictive cutoff value to identify the “high-grade rotatory instability” group, with an accuracy of 77.8% and 74.4% and a specificity of 95.5% and 93.9% referred to the PS ACC and PS IE, respectively.Conclusion:The presence of a lateral LNS deeper than 2 mm could be used for the preoperative identification of patients with a high risk of increased rotatory instability. |
| Databáze: | OpenAIRE |
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