Current concept in rotational laxity control and evaluation in ACL reconstruction

Area of Science:

• Orthopedics
• Biomechanics
• Sports Medicine

Background:

• Anterior cruciate ligament (ACL) deficiency significantly impacts knee joint stability.
• Research focus has shifted from translation to rotational laxity in ACL-injured knees.
• Recent advancements have led to numerous studies and devices for assessing knee rotation.

Purpose of the Study:

• To critically analyze the existing literature on knee rotational laxity in ACL-deficient knees.
• To clarify current knowledge regarding the complex 3D motion involving rotation and translation.
• To review and compare various methods and devices used for assessing rotational laxity.

Main Methods:

• Literature review and critical analysis of published studies.
• Categorization of rotational laxities: coupled with translation, rotational envelope, and active rotation (Pivot-shift test).
• Review of mechanical, radiological, and navigation-based assessment devices (optoelectronic, electromagnetic).

Main Results:

• Different types of rotational laxities are identified and analyzed in the context of ACL deficiency.
• The role of ACL bundles in knee rotation is examined.
• Various static and dynamic testing conditions and assessment technologies are presented.

Conclusions:

• Understanding knee rotational laxity is crucial for ACL-deficient knees.
• Advancements in assessment technologies, including navigation systems and accelerometers, are improving the evaluation of rotational laxity.
• Further research utilizing these advanced tools is promising for clinical applications.