Quantitative Assessment of Pivot-shift Using Inertial Sensors

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2012 Jan 7

PMID 22222615

Citations 46

Authors

Nicola Lopomo

Cecilia Signorelli

Tommaso Bonanzinga

Giulio Maria Marcheggiani Muccioli

Andrea Visani

Stefano Zaffagnini

Affiliations

Soon will be listed here.

Abstract

Purpose: The pivot-shift phenomenon has been identified to be one of the essential signs of functional anterior cruciate ligament (ACL) insufficiency. However, the pivot-shift test remains a surgeon-subjective examination, lacking a general recognized quantitative measurement. The goal of the present study was to validate the use of an inertial sensor for quantifying the pivot-shift test, using a commercial navigation system.

Methods: An expert surgeon intra-operatively performed the pivot-shift test on 15 consecutive patients before ACL reconstruction. A single accelerometer and a commercial navigation system simultaneously acquired limb kinematics. An additional optical tracker mounted on the accelerometer allowed following sensor movements. Anteroposterior (a-p) tibial acceleration obtained with the navigation system was compared with three-dimensional (3D) acceleration acquired by the accelerometer. The effect of skin artifacts and test-retest positioning were estimated. Repeatability of the acceleration parameter and waveform was analyzed. Correlation between the two measurements was also assessed.

Results: Average root mean square (RMS) error in test-retest positioning reported a good value of 5.5 ± 2.9 mm. Mean RMS displacement due to soft tissue artifacts was 4.9 ± 2.6 mm. The analysis of acceleration range repetitions reported a good intra-tester repeatability (Cronbach's alpha = 0.86). Inter-patients similarity analysis showed a mean acceleration waveform correlation of 0.88 ± 0.14. The acceleration ranges demonstrated a good positive correlation between the two measurements (rs = 0.72, P < 0.05).

Conclusion: This study showed good reliability of the new device and good correlation with the navigation system results. Therefore, the accelerometer is a valid method to assess dynamic joint laxity.

Level Of Evidence: II.

Citing Articles

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Wearable sensor systems measure differences in knee laxity between healthy and affected knees during dynamic exercise activities: A systematic review.

van Eijck S, Vugts M, Janssen R, Hoogendoorn I, Ito K, Van der Steen M J Exp Orthop. 2024; 11(3):e12094.

PMID: 39055395 PMC: 11269365. DOI: 10.1002/jeo2.12094.

Mobile App for Enhanced Anterior Cruciate Ligament (ACL) Assessment in Conscious Subjects: "Pivot-Shift Meter".

Berumen-Nafarrate E, Ramos-Moctezuma I, Sigala-Gonzalez L, Quintana-Trejo F, Tonche-Ramos J, Portillo-Ortiz N J Pers Med. 2024; 14(6).

PMID: 38929873 PMC: 11204776. DOI: 10.3390/jpm14060651.

Association Between MRI Signal Intensity of the Repaired Lateral Meniscus and Residual Anterolateral Knee Laxity After ACL Reconstruction.

Chiba D, Yamamoto Y, Kimura Y, Sasaki E, Sasaki S, Tsuda E Orthop J Sports Med. 2024; 12(4):23259671241241821.

PMID: 38628462 PMC: 11020732. DOI: 10.1177/23259671241241821.

Posterior tibial plateau impaction fractures are not associated with increased knee instability: a quantitative pivot shift analysis.

Godshaw B, Hughes J, Lucidi G, Setliff J, Sansone M, Karlsson J Knee Surg Sports Traumatol Arthrosc. 2023; 31(7):2998-3006.

PMID: 36633602 DOI: 10.1007/s00167-023-07312-3.

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