Anterior cruciate ligament assessment using arthrometry and stress imaging

Rohman, Eric; Macalena, Jeffrey A.

doi:10.1007/s12178-016-9331-1

Cited by 30 publications

(38 citation statements)

References 97 publications

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“…Tibiofemoral angle and medial and lateral gaps throughout the range of knee motion after UKA were recorded using the navigation software to confirm adequate coronal knee correction. A second surgeon who was blinded to the degree of slope assessed the anterior knee stability using two testing methods: knee arthrometry (KT-2000, MEDmetric, San Diego, CA, USA) 15 at both 20° and 90° of knee flexion and stress radiography 16 with the knee flexed 20° (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

Posterior tibial slope modification in osteoarthritis knees with different ACL conditions: Cadaveric study of fixed-bearing UKA

Adulkasem

Rojanasthien

Siripocaratana

et al. 2019

J Orthop Surg (Hong Kong)

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Unicompartmental knee arthroplasty (UKA) in anterior cruciate ligament deficiency (ACLD) has been debated for decades after the development of highly cross-linked polyethylene. This study aims to evaluate the effect of posterior tibial slope on restoring adequate knee stability and flexion after UKA in patients with ACLD. A total of 15 fresh cadaveric knees were divided into three groups: intact ACL, partial ACLD, and complete ACLD. Fixed-bearing UKAs including 3-D-printed tibial inserts with the slopes ranging from 3 to 12 were performed using computer-assisted navigation. Blinded evaluation of knee motion and anterior knee translation with knees flexed 20 and 90 was conducted using KT-arthrometry and stress radiography. A 1 slope increase translated the knees anteriorly by 0.85 mm and 0.76 mm in 20 and 90 of knee flexion for a complete ACLD (R ¼ 0.7 and 0.8, respectively, p < 0.001) compared to 0.5-0.6 mm for the normal and partial ACLD groups, respectively. Setting a slope of 5-8 of UKA for an intact ACL maintained both the stability and the motion of native knees. No significant changes of knee translation and flexion ability were observed after leveling the slopes at 5-7 and 5-6 for partial and complete ACLD, respectively (p > 0.05 for all comparisons). In conclusion, UKA in complete ACLD knees is challenging since 1 of slope change nearly doubles the degree of knee translation compared to ACL-intact knees. The optimum posterior tibial slopes for fixed-bearing UKA patients with partial and complete ACLD are 5-7 and 5-6 , respectively.

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Section: Methodsmentioning

confidence: 99%

Posterior tibial slope modification in osteoarthritis knees with different ACL conditions: Cadaveric study of fixed-bearing UKA

Adulkasem

Rojanasthien

Siripocaratana

et al. 2019

J Orthop Surg (Hong Kong)

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“…Most authors have recommended knee flexion angle ranging from 10°to 30°for stress test, especially 20° [9,13,30]. However, majority of them did not specify the reference line for knee flexion angle.…”

Section: Discussionmentioning

confidence: 99%

Anterior tibial displacement on preoperative stress radiography of ACL-injured knee depending on knee flexion angle

Noh

Nam

Roh

2019

Knee Surg & Relat Res

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Purpose: To compare side-to-side difference (SSD) of anterior tibial translation in instrumented stress radiography for each series of anterior cruciate ligament (ACL)-injured subjects according to knee flexion angle. Methods: Forty subjects who were suspected of having significant ACL injury by manual Lachman test and MRI were recruited for this prospective study. These subjects took stress radiographs for both knees with corresponding knee flexion of 10°(series M1) and 30°(series M2) using Telos stress device. Mean SSDs of M1 and M2 were compared. Sensitivities of M1 and M2 were assessed using the SSD ≥ 3 mm or ≥ 5 mm as a cutoff value. Results: Mean SSDs in series M1 and M2 were 4.22 ± 3.72 mm and 3.25 ± 3.30 mm, respectively (p < 0.001). When 3 mm of SSD was used as a cutoff value, sensitivities of series M1 and M2 were 47.5% (19/40) and 32.5% (13/40), respectively (p = 0.171). When 5 mm of SSD was used as a cutoff value, sensitivities of series M1 and M2 were 45.0% (18/40) and 22.5% (9/40), respectively (p = 0.033). Conclusions: Anterior tibial translation on stress radiographs using a Telos device is more prominent when knee flexion angle is 10°compared to that when knee flexion angle is 30°. However, stress radiography using Telos device, either at 10°or 30°of knee flexion, might not be suitable to make decision on surgical treatment due to relatively low sensitivities.

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“…At least as reliable as the KT-1000 [ 89 ] GNRB ® Sensitivity and specificity for an ACL tear ranging between 62% to 92% and 76% to 99%, respectively [ 11 , 57 , 90 ] Measure anterior tibial displacement in mm The inter-tester ICC has been reported ranging between 0.220 and 0.424 [ 114 ] Robotic testing meaning a less examiner-dependent measurement. Several studies reporting the GNRB as reliable or superior to other arthrometers [ 91 ] Possible to account for patient guarding with hamstring activation [ 90 ] Pivot App Excellent inter- and intra-tester reliability reported. Inter-tester ICC 0.95 (95% CI 0.54–1.00), intra-tester ICC ranging between 0.91 and 0.99 (95% CI 0.319–1.000) [ 75 ] Lateral tibial translation during the pivot shift test is calculated (in mm) by a software program analyzing the movement of three markers placed on the skin during video recording of the pivot shift test using a commercial tablet Been proved valid to detect differences between clinically high- and low-grade pivot shift [ 77 ] KiRa Mean intra-rater ICC 0.79.…”

Section: Clinical Outcome Assessmentmentioning

confidence: 99%

Clinical outcomes after anterior cruciate ligament injury: panther symposium ACL injury clinical outcomes consensus group

Svantesson

Senorski

Webster

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose A stringent outcome assessment is a key aspect for establishing evidence-based clinical guidelines for anterior cruciate ligament (ACL) injury treatment. The aim of this consensus statement was to establish what data should be reported when conducting an ACL outcome study, what specific outcome measurements should be used and at what follow-up time those outcomes should be assessed. Methods To establish a standardized approach to assessment of clinical outcome after ACL treatment, a consensus meeting including a multidisciplinary group of ACL experts was held at the ACL Consensus Meeting Panther Symposium, Pittsburgh, PA; USA, in June 2019. The group reached consensus on nine statements by using a modified Delphi method. Results In general, outcomes after ACL treatment can be divided into four robust categories—early adverse events, patient-reported outcomes, ACL graft failure/recurrent ligament disruption and clinical measures of knee function and structure. A comprehensive assessment following ACL treatment should aim to provide a complete overview of the treatment result, optimally including the various aspects of outcome categories. For most research questions, a minimum follow-up of 2 years with an optimal follow-up rate of 80% is necessary to achieve a comprehensive assessment. This should include clinical examination, any sustained re-injuries, validated knee-specific PROs and Health-Related Quality of Life questionnaires. In the mid- to long-term follow-up, the presence of osteoarthritis should be evaluated. Conclusion This consensus paper provides practical guidelines for how the aforementioned entities of outcomes should be reported and suggests the preferred tools for a reliable and valid assessment of outcome after ACL treatment. Level of evidence V.

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Anterior cruciate ligament assessment using arthrometry and stress imaging

Cited by 30 publications

References 97 publications

Posterior tibial slope modification in osteoarthritis knees with different ACL conditions: Cadaveric study of fixed-bearing UKA

Posterior tibial slope modification in osteoarthritis knees with different ACL conditions: Cadaveric study of fixed-bearing UKA

Anterior tibial displacement on preoperative stress radiography of ACL-injured knee depending on knee flexion angle

Clinical outcomes after anterior cruciate ligament injury: panther symposium ACL injury clinical outcomes consensus group

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