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Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
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A new quantitative method for pivot shift grading.

S Kopf1, R Kauert, J Halfpaap

  • 1Section Sports Traumatology and Arthroscopy, Center for Musculoskeletal Surgery, Charité, University Medicine, Berlin, Germany.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|February 11, 2012
PubMed
Summary
This summary is machine-generated.

This study shows inertial sensors can quantify the pivot shift phenomenon in anterior cruciate ligament (ACL) tears. Objective sensor data did not correlate with subjective examiner grading of the pivot shift test.

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Area of Science:

  • Orthopedic Surgery
  • Biomechanics
  • Sports Medicine

Background:

  • The pivot shift test is a clinical examination for anterior cruciate ligament (ACL) instability.
  • Accurate quantification of the pivot shift phenomenon remains challenging.
  • Objective measurement methods are needed to supplement subjective clinical grading.

Purpose of the Study:

  • To evaluate and quantify the pivot shift phenomenon using a novel, handheld device.
  • To assess the reliability of inertial sensors in measuring pivot shift.
  • To compare objective sensor-based measurements with subjective clinical grading.

Main Methods:

  • Twenty patients with primary ACL tears underwent testing under anesthesia.
  • Miniature inertial sensors (femoral and tibial) measured acceleration and angular velocities.
  • Three parameters (a(diff), j(max), SD(a)) were used for pivot shift quantification.
  • Data was normalized by comparing ACL-deficient knees to intact knees.

Main Results:

  • The pivot shift phenomenon was successfully identified using inertial sensors.
  • All three quantified parameters showed significantly higher values in ACL-deficient knees (p < 0.05).
  • Subjective examiner grading did not significantly correlate with objective sensor-based parameters or device grading.

Conclusions:

  • Quantification of the pivot shift test is feasible using inertial sensors.
  • Objective measurement provides a reliable method for assessing pivot shift.
  • Subjective clinical grading of the pivot shift test shows poor correlation with objective quantification.