Triaxial accelerometer evaluation is correlated with IKDC grade of pivot shift
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The purpose of this study was to evaluate the correlation between tibial acceleration parameters measured by the KiRA device and the clinical grade of pivot shift. The secondary objective was to report the risk factors for pre-operative high-grade pivot shift.
Two-hundred and ninety-five ACL deficient patients were examined under anesthesia. The pivot shift tests were performed twice by an expert surgeon. Clinical grading was performed using the International Knee Documentation Committee (IKDC) scale and tibial acceleration data was recorded using a triaxial accelerometer system (KiRA). The difference in the tibial acceleration range between injured and contralateral limbs was used in the analysis. Correlation coefficients were calculated using linear regression. Multivariate logistic regression was used to identify risk factors for high grade pivot shift.
The clinical grade of pivot shift and the side-to-side difference in delta tibial acceleration determined by KiRA were significantly correlated (r = 0.57; 95% CI 0.513–0.658, p < 0.0001). The only risk factor identified to have a significant association with high grade pivot shift was an antero-posterior side to side laxity difference > 6 mm (OR = 2.070; 95% CI (1.259–3.405), p = 0.0042).
Side-to-side difference in tibial acceleration range, as measured by KiRA, is correlated with the IKDC pivot shift grade in anaesthetized patients. Side-to-side A–P laxity difference greater than 6 mm is reported as a newly defined risk factor for high grade pivot shift in the ACL injured knee.
KeywordsPivot shift grade Quantitative pivot shift Anterior cruciate ligament Antero-posterior laxity
This study received no financial support or grant.
Compliance with ethical standards
Conflict of interest
One or more of the authors has declared the following potential conflict of interest or source of funding: B.S.-C. receives royalties from, is a paid consultant for, receives research support from, and has made presentations for Arthrex Inc. M.T. is a paid consultant for, receives research support from, and has made presentations for Arthrex. J-M.F. is a paid consultant, receives research support and has made presentations for Arthrex. A.S. is a paid consultant for Arthrex.
Institutional review board approval (COS-RGDS-2018-07-002) was granted for this study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
All patients gave valid written consent to participate.
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