Summary

There is no clinically relevant correlation between Knee Functional Scores or Quality of Life Questionnaire and Pivot Shift Test Measurements in Patients with Anterior Cruciate Ligament Injury

Abstract

Introduction

Non-invasive devices for measuring the pivot shift test have been validated in the medical literature. Examples of these devices include an iPad® application that measures the anterior translation of the lateral tibial plateau relative to the femur and inertial sensors that detect tibial acceleration during the reduction phase of the pivot shift test. The aim of this study is to determine whether subjective or quantitative measurements of the pivot shift test correlate with knee functional scores and quality of life in patients with anterior cruciate ligament (ACL) injuries. We hypothesize that higher quantitative pivot shift test results will be associated with poorer functional and quality-of-life scores in ACL-injured patients.

Methods

Sixty patients with ACL injury, who participated in Level 1 or 2 sports activities and were indicated for surgical treatment, completed the Lysholm score, subjective International Knee Documentation Committee (IKDC) score, and the SF-36 quality of life questionnaire. The pivot shift test was performed under anesthesia by the same surgeon in all 60 patients, who also assigned a clinical grading according to the IKDC criteria. In addition, the pivot shift test was quantitatively measured using an image analysis application for iPad® and an inertial sensor (accelerometer). The Spearman correlation coefficient was used to evaluate the relationship between the pivot shift test grading and its quantitative measurements with the functional and quality of life scores obtained from the questionnaires.

Results

Only a weak negative correlation was found between the clinical grading of the pivot shift test and the SF-36 Mental Health domain (p < 0.05; Spearman = -0.278). No other correlations were statistically significant between any measurement device and the functional scores or SF-36 domains.

Conclusions

Only the clinical and subjective grading of the pivot shift test under anesthesia showed a weak correlation with the Mental Health domain of the SF-36. The pivot shift test measured by non-invasive devices did not demonstrate statistically significant correlation with the subjective functional scores or quality of life questionnaire used in this study.