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Development of Electromagnetic Tracking for the Pivot Shift

  • Ryosuke KurodaEmail author
  • Yuichi Hoshino
  • Takehiko Matsushita
  • Kouki Nagamune
  • Masahiro Kurosaka
Chapter
  • 1.1k Downloads

Abstract

Anterior cruciate ligament (ACL) insufficiency is clinically diagnosed by manual tests, such as the pivot-shift and the Lachman tests. These manual tests are used not only for diagnosing a primary ACL injury but also as an outcome measure after ACL reconstruction. The pivot-shift examination has significant associations with both patient satisfaction and overall knee function and may be a better measure of “functional instability.” Residual laxity can be detected by the pivot-shift test in ACL-reconstructed knees in which anterior laxity has been successfully restored. Given of the ability to evaluate a dynamic and a rotational component of the knee laxity, a postoperative stability evaluation should include the pivot-shift test. An electromagnetic tracking device can measure the 6 degrees-of-freedom knee kinematics during the pivot-shift test providing dynamic 3D tibial displacement relative to the femur. This device detected the increase of the tibial anterior translation by about 8 mm and the increase of tibial posterior acceleration by about 1 m/sec2 in ACL-deficient knees compared to the contralateral intact knees. This in vivo measurement can be applied for quantitative evaluation of the dynamic laxity during the pivot-shift test.

Keywords

Anterior cruciate pivot-shift test Rotational instability Electromagnetic device Knee kinematics 

References

  1. 1.
    Adachi N, Ochi M, Uchio Y et al (2004) Reconstruction of the anterior cruciate ligament. Single- versus double-bundle multistranded hamstring tendons. J Bone Joint Surg Br 86(4):515–520PubMedGoogle Scholar
  2. 2.
    Allum R, Jones D, Mowbray MA et al (1984) Triaxial electrogoniometric examination of the pivot shift sign for rotatory instability of the knee. Clin Orthop Relat Res 183:144–146PubMedGoogle Scholar
  3. 3.
    Andersson C, Gillquist J (1990) Instrumented testing for evaluation of sagittal knee laxity. Clin Orthop Relat Res 256:178–184PubMedGoogle Scholar
  4. 4.
    Araki D, Kuroda R, Kubo S et al (2011) A prospective randomised study of anatomical single-bundle versus double-bundle anterior cruciate ligament reconstruction: quantitative evaluation using an electromagnetic measurement system. Int Orthop 35(3):439–446CrossRefPubMedGoogle Scholar
  5. 5.
    Bedi A, Musahl V, O’Loughlin P et al (2010) A comparison of the effect of central anatomical single-bundle anterior cruciate ligament reconstruction and double-bundle anterior cruciate ligament reconstruction on pivot-shift kinematics. Am J Sports Med 38(9):1788–1794CrossRefPubMedGoogle Scholar
  6. 6.
    Bignozzi S, Zaffagnini S, Lopomo N et al (2010) Clinical relevance of static and dynamic tests after anatomical double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 18(1):37–42CrossRefPubMedGoogle Scholar
  7. 7.
    Bull AM, Earnshaw PH, Smith A et al (2002) Intraoperative measurement of knee kinematics in reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br 84(7):1075–1081CrossRefPubMedGoogle Scholar
  8. 8.
    Daniel DM, Stone ML, Dobson BE (1994) Fate of the ACL-injured patient. A prospective outcome study. Am J Sports Med 22(5):632–644CrossRefPubMedGoogle Scholar
  9. 9.
    Daniel DM, Malcom LL, Losse G et al (1985) Instrumented measurement of anterior laxity of the knee. J Bone Joint Surg Am 67(5):720–726PubMedGoogle Scholar
  10. 10.
    Ferretti A, Conteduca F, De Carli A et al (1991) Osteoarthritis of the knee after ACL reconstruction. Int Orthop 15(4):367–371CrossRefPubMedGoogle Scholar
  11. 11.
    Galway HR, MacIntosh DL (1980) The lateral pivot shift: a symptom and sign of anterior cruciate ligament insufficiency. Clin Orthop Relat Res 147:45–50PubMedGoogle Scholar
  12. 12.
    Ganko A, Engebretsen L, Ozer H (2000) The rolimeter: a new arthrometer compared with the KT-1000. Knee Surg Sports Traumatol Arthrosc 8(1):36–39CrossRefPubMedGoogle Scholar
  13. 13.
    Gillquist J, Messner K (1995) Instrumented analysis of the pivot shift phenomenon after reconstruction of the anterior cruciate ligament. Int J Sports Med 16(7):484–488CrossRefPubMedGoogle Scholar
  14. 14.
    Grood ES, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng 105(2):136–144CrossRefPubMedGoogle Scholar
  15. 15.
    Hoshino Y, Kuroda R, Nagamune K et al (2007) In vivo measurement of the pivot-shift test in the anterior cruciate ligament-deficient knee using an electromagnetic device. Am J Sports Med 35(7):1098–1104CrossRefPubMedGoogle Scholar
  16. 16.
    Hoshino Y, Kuroda R, Nagamune K et al (2012) Optimal measurement of clinical rotational test for evaluating anterior cruciate ligament insufficiency. Knee Surg Sports Traumatol Arthrosc 20(7):1323–1330CrossRefPubMedGoogle Scholar
  17. 17.
    Hoshino Y, Araujo P, Ahlden M et al (2013) Quantitative evaluation of the pivot shift by image analysis using the iPad. Knee Surg Sports Traumatol Arthrosc 21(4):975–980CrossRefPubMedGoogle Scholar
  18. 18.
    Irrgang JJ, Anderson AF, Boland AL et al (2001) Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med 29(5):600–613PubMedGoogle Scholar
  19. 19.
    Irrgang JJ, Bost JE, Fu FH (2009) Re: outcome of single-bundle versus double-bundle reconstruction of the anterior cruciate ligament: a meta-analysis. Am J Sports Med 37(2):421–422; author reply 422CrossRefPubMedGoogle Scholar
  20. 20.
    Jakob RP, Staubli HU, Deland JT (1987) Grading the pivot shift. Objective tests with implications for treatment. J Bone Joint Surg Br 69(2):294–299PubMedGoogle Scholar
  21. 21.
    Jarvela T, Moisala AS, Sihvonen R et al (2008) Double-bundle anterior cruciate ligament reconstruction using hamstring autografts and bioabsorbable interference screw fixation: prospective, randomized, clinical study with 2-year results. Am J Sports Med 36(2):290–297CrossRefPubMedGoogle Scholar
  22. 22.
    Jonsson H, Riklund-Ahlstrom K, Lind J (2004) Positive pivot shift after ACL reconstruction predicts later osteoarthrosis: 63 patients followed 5–9 years after surgery. Acta Orthop Scand 75(5):594–599CrossRefPubMedGoogle Scholar
  23. 23.
    Kanamori A, Zeminski J, Rudy TW (2002) The effect of axial tibial torque on the function of the anterior cruciate ligament: a biomechanical study of a simulated pivot shift test. Arthroscopy 18(4):394–398CrossRefPubMedGoogle Scholar
  24. 24.
    Kocher MS, Steadman JR, Briggs KK, et al (2004)Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction. Am J Sports Med 32(3):629–634Google Scholar
  25. 25.
    Kondo E, Yasuda K, Azuma H et al (2008) Prospective clinical comparisons of anatomic double-bundle versus single-bundle anterior cruciate ligament reconstruction procedures in 328 consecutive patients. Am J Sports Med 36(9):1675–1687CrossRefPubMedGoogle Scholar
  26. 26.
    Kondo E, Merican AM, Yasuda K et al (2010) Biomechanical comparisons of knee stability after anterior cruciate ligament reconstruction between 2 clinically available transtibial procedures: anatomic double bundle versus single bundle. Am J Sports Med 38(7):1349–1358CrossRefPubMedGoogle Scholar
  27. 27.
    Kubo S, Muratsu H, Yoshiya S et al (2007) Reliability and usefulness of a new in vivo measurement system of the pivot shift. Clin Orthop Relat Res 454:54–58CrossRefPubMedGoogle Scholar
  28. 28.
    Kuroda R, Hoshino Y, Kubo S et al (2012) Similarities and differences of diagnostic manual tests for anterior cruciate ligament insufficiency: a global survey and kinematics assessment. Am J Sports Med 40(1):91–99CrossRefPubMedGoogle Scholar
  29. 29.
    Kuroda R, Hoshino Y, Araki D et al (2012) Quantitative measurement of the pivot shift, reliability, and clinical applications. Knee Surg Sports Traumatol Arthrosc 20(4):686–691CrossRefPubMedGoogle Scholar
  30. 30.
    Labbe DR, de Guise JA, Mezghani N et al (2010) Feature selection using a principal component analysis of the kinematics of the pivot shift phenomenon. J Biomech 43(16):3080–3084CrossRefPubMedGoogle Scholar
  31. 31.
    Logan MC, Williams A, Lavelle J et al (2004) Tibiofemoral kinematics following successful anterior cruciate ligament reconstruction using dynamic multiple resonance imaging. Am J Sports Med 32(4):984–992CrossRefPubMedGoogle Scholar
  32. 32.
    Loh JC, Fukuda Y, Tsuda E et al (2003) Knee stability and graft function following anterior cruciate ligament reconstruction: Comparison between 11 o’clock and 10 o’clock femoral tunnel placement. 2002 Richard O’Connor Award paper. Arthroscopy 19(3):297–304CrossRefPubMedGoogle Scholar
  33. 33.
    Lopomo N, Zaffagnini S, Signorelli C et al (2012) An original clinical methodology for non-invasive assessment of pivot-shift test. Comput Methods Biomech Biomed Engin 15(12):1323–1328CrossRefPubMedGoogle Scholar
  34. 34.
    Losee RE (1983) Concepts of the pivot shift. Clin Orthop Relat Res 172:45–51PubMedGoogle Scholar
  35. 35.
    Mae T, Shino K, Miyama T et al (2001) Single- versus two-femoral socket anterior cruciate ligament reconstruction technique: Biomechanical analysis using a robotic simulator. Arthroscopy 17(7):708–716CrossRefPubMedGoogle Scholar
  36. 36.
    Maeyama A, Hoshino Y, Debandi A et al (2011) Evaluation of rotational instability in the anterior cruciate ligament deficient knee using triaxial accelerometer: a biomechanical model in porcine knees. Knee Surg Sports Traumatol Arthrosc 19(8):1233–1238CrossRefPubMedGoogle Scholar
  37. 37.
    Matsumoto H (1990) Mechanism of the pivot shift. J Bone Joint Surg Br 72(5):816–821PubMedGoogle Scholar
  38. 38.
    Meredick RB, Vance KJ, Appleby D et al (2008) Outcome of single-bundle versus double-bundle reconstruction of the anterior cruciate ligament: a meta-analysis. Am J Sports Med 36(7):1414–1421CrossRefPubMedGoogle Scholar
  39. 39.
    Muneta T, Koga H, Mochizuki T et al (2007) A prospective randomized study of 4-strand semitendinosus tendon anterior cruciate ligament reconstruction comparing single-bundle and double-bundle techniques. Arthroscopy 23(6):618–628CrossRefPubMedGoogle Scholar
  40. 40.
    Musahl V, Voos JE, O’Loughlin PF et al (2010) Comparing stability of different single- and double-bundle anterior cruciate ligament reconstruction techniques: a cadaveric study using navigation. Arthroscopy 26(9 Suppl):S41–S48CrossRefPubMedGoogle Scholar
  41. 41.
    Noyes FR, Grood ES, Cummings JF et al (1991) An analysis of the pivot shift phenomenon. The knee motions and subluxations induced by different examiners. Am J Sports Med 19(2):148–155CrossRefPubMedGoogle Scholar
  42. 42.
    Oliver JH, Coughlin LP (1987) Objective knee evaluation using the genucom knee analysis system. Clinical implications. Am J Sports Med 15(6):571–578CrossRefPubMedGoogle Scholar
  43. 43.
    Plaweski S, Grimaldi M, Courvoisier A et al (2011) Intraoperative comparisons of knee kinematics of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 19(8):1277–1286CrossRefPubMedGoogle Scholar
  44. 44.
    Ristanis S, Giakas G, Papageorgiou CD, et al (2003) The effects of anterior cruciate ligament reconstruction on tibial rotation during pivoting after descending stairs. Knee Surg Sports Traumatol Arthrosc 11(6):360–365Google Scholar
  45. 45.
    Schuster AJ, McNicholas MJ, Wachtl SW, et al (2004) A new mechanical testing device for measuring anteroposterior knee laxity. Am J Sports Med 32(7):1731–1735Google Scholar
  46. 46.
    Siebold R, Dehler C, Ellert T (2008) Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Arthroscopy 24(2):137–145CrossRefPubMedGoogle Scholar
  47. 47.
    Slocum DB, James SL, Larson RL et al (1976) Clinical test for anterolateral rotary instability of the knee. Clin Orthop Relat Res 118:63–69PubMedGoogle Scholar
  48. 48.
    Snyder-Mackler L, Fitzgerald GK, Bartolozzi AR 3rd et al (1997) The relationship between passive joint laxity and functional outcome after anterior cruciate ligament injury. Am J Sports Med 25(2):191–195CrossRefPubMedGoogle Scholar
  49. 49.
    Tashman S, Collon D, Anderson K et al (2004) Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med 32(4):975–983CrossRefPubMedGoogle Scholar
  50. 50.
    Torg JS, Conrad W, Kalen V (1976) Clinical diagnosis of anterior cruciate ligament instability in the athlete. Am J Sports Med 4(2):84–93CrossRefPubMedGoogle Scholar
  51. 51.
    Tsai AG, Wijdicks CA, Walsh MP et al (2010) Comparative kinematic evaluation of all-inside single-bundle and double-bundle anterior cruciate ligament reconstruction: a biomechanical study. Am J Sports Med 38(2):263–272CrossRefPubMedGoogle Scholar
  52. 52.
    Weiss JR, Irrgang JJ, Sawhney R et al (1990) A functional assessment of anterior cruciate ligament deficiency in an acute and clinical setting. J Orthop Sports Phys Ther 11(8):372–373CrossRefPubMedGoogle Scholar
  53. 53.
    Yagi M, Wong EK, Kanamori A, et al (2004) Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30(5):660–666Google Scholar
  54. 54.
    Yagi M, Kuroda R, Nagamune K et al (2007) Double-bundle ACL reconstruction can improve rotational stability. Clin Orthop Relat Res 454:100–107CrossRefPubMedGoogle Scholar
  55. 55.
    Yasuda K, Kondo E, Ichiyama H et al (2006) Clinical evaluation of anatomic double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts: comparisons among 3 different procedures. Arthroscopy 22(3):240–251CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Ryosuke Kuroda
    • 1
    Email author
  • Yuichi Hoshino
    • 2
  • Takehiko Matsushita
    • 1
  • Kouki Nagamune
    • 3
  • Masahiro Kurosaka
    • 1
  1. 1.Department of Orthopaedic Surgery, Graduate School of MedicineKobe UniversityKobeJapan
  2. 2.Department of Orthopaedic SurgeryKobe Kaisei HospitalKobeJapan
  3. 3.Department of Human and Artificial Intelligent Systems, Graduate School of EngineeringUniversity of FukuiFukuiJapan

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