PSM: Pivot Shift Meter Cellphone Application for Classifying ACL Injuries

Carlos Alejandro Vega Nájera, Joel Cabral Guzmán, Luis Raúl Sigala González, Avril Pérez Fontes, Jesús Javier Tonche Ramos, Iván René Ramos Moctezuma, Fátima Norely Quintana Trejo, Carlos Leal Contreras, Edmundo Berumen Nafarrate

Christus Muguerza del Parque Hospital, Chihuahua, México

Background

Anterior Cruciate Ligament (ACL) lesions are frequent in knee rotational and sports injuries, and rotational instability is the most important factor to determine long term outcomes and failures. An accurate endorsement of the pivot shift test is key to define therapeutic paths. But this test cannot be numerically measured, and the gold standard KT-1000 test can only measure the anterior translation of the tibia over the femur. A precise measurement of pivot shift could give an advantage in determining the rotational instability of both ACL bundles.

Hypothesis

The rotational stability of the knee can be accurately measured using a mobile phone application.

Materials And Methods

A technological application named Pivot Shift Meter (PSM) was designed to provide a dynamic evaluation of rotational stability of the knee, measured in rad/s (angular velocity) through the gyroscope integrated in a mobile phone. The evaluation of 52 young, healthy subjects was obtained by 5 different medical practitioners. The time and maximum velocity reached of each maneuver was then used in intraclass correlation coefficient (ICC) study to find the differences between the practitioner’s maneuvers. The correlation study variables were maneuver time and amplitude of maximum speed. Then the data obtained with the PSM was analyzed to create a classification of injury degree, using an already established classification named as the “Del Parque'' Classification obtained through the KT1000.

Results

The ICC study results in terms of time and maximum velocity reached give an average result of 94% and of 66%, respectively, from an interobserver correlation. These results demonstrated that a quantitative analysis of the maneuver can be carried out through the application. From these correlation results, the samples were grouped into classes determined by the speed of the maneuver reached and then analyzing each sample to determine the degree of injury. These analysis results were compared against the KT1000 classification, and it was found that 95% of the cases were classifiable, with 7 extra cases detected by the PSM.

Conclusions

In the present study PSM was able to precisely measure rotational instability, providing quantitative dynamic diagnostic information that the gold standard arthrometer cannot offer.
Digital arthrometry seems to be the way to develop methods for the precise and numerical evaluation of rotational instability, with all the advantages that an early diagnosis and classification prior to any surgical treatment can provide.

Level of Evidence: Case - Control Study

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Sex Related Outcomes Following Anterior Cruciate Ligament Reconstruction (Aclr): A Systematic Review and Meta-Analysis Abstract Presentation 5 minutes Anthony Charles Mok, BS, UNITED STATES Andrew J Fancher, BS, UNITED STATES Matthew L Vopat, MD, UNITED STATES Jordan Charles Baker, BS, UNITED STATES Armin Tarakemeh, BS, UNITED STATES Mary K. Mulcahey, MD, UNITED STATES Scott Mullen, MD, UNITED STATES Paul Schroeppel, MD, UNITED STATES Kimberly J. Templeton, MD, UNITED STATES Bryan Vopat, UNITED STATES
The Use Of An Internal Brace In A Single Bundle Hamstring Graft And Its Effect On Graft Healing At 1 Year After Anterior Cruciate Ligament Reconstruction ePoster Presentation Claire Bolton, FRACS, MBBS, AUSTRALIA Brett A. Fritsch, MBBS BSc(Med), FRACS, FAOrthA, AUSTRALIA David A. Parker, MBBS, BMedSc, FRACS, AUSTRALIA Bruno M. Giuffré, MD, AUSTRALIA
A Comparison of Lower Limb Strength and Plyometric Ability in Athletes who underwent ACLR with Lateral Extra-Articular Ilio-Tibial Band Tenodesis when compared with Isolated ACLR Surgery. A Biomechanical Study. Abstract Presentation 7 minutes Bláithín Brady, BSc MSc , IRELAND Sarah Crosbie, BSc, IRELAND Neil Welch, BSc MSc PhD, IRELAND Mihai Vioreanu, MD, MCh, FFSEM, FRCSI(Tr&Orth), IRELAND
Validation of a Risk Calculator to Personalize Graft Choice and Reduce Rupture Rates for Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Hana Marmura, MPT, PhD, UNITED STATES Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR Kurt Paul Spindler, MD, UNITED STATES Michael W Kattan, PhD, UNITED STATES Isaac Briskin, MA, UNITED STATES Dianne M. Bryant, PhD, CANADA
Changes In Muscle Strength And Hop Performance After ACL Reconstruction. A Randomized Controlled Trial Comparing Patellar Tendon And Hamstring Tendon Autografts With Standard Or Accelerated Rehabilitation Abstract Presentation 6 minutes Riccardo Cristiani, MD, PhD, SWEDEN Christina Mikkelsen, PT, SWEDEN Peter Olov Wange, MD, SWEDEN Daniel Olsson, PhD, SWEDEN Anders Stalman, MD, PhD, Professor, SWEDEN Bjorn Engstrom, MD, PhD, Assoc. Prof., SWEDEN
Posterior Tibial Plateau Impaction Fractures Are Not Associated With Increased Knee Instability: A Quantitative Pivot Shift Analysis Abstract Presentation 8 minutes Brian M Godshaw, MD, UNITED STATES Joshua C Setliff, BA, UNITED STATES Jonathan D Hughes, MD, PhD, UNITED STATES Volker Musahl, MD, Prof., UNITED STATES
Early Return To Sport After Quadriceps Tendon Autograft ACL Reconstruction: Comparison To Bone-Patellar Tendon-Bone Autograft At A Minimum 1-Year Follow-Up ePoster Presentation Evan W. James, MD, UNITED STATES Dakota Adamec , BS , UNITED STATES Spencer Sullivan, BS, UNITED STATES Per-Henrik Randsborg, MD, PhD, NORWAY Brandon Schneider, MS, UNITED STATES Robert G. Marx, MD, UNITED STATES Answorth A. Allen, MD, UNITED STATES Frank A. Cordasco, MD, MS, UNITED STATES Benedict U. Nwachukwu, MD, MBA, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
Ligamentous Laxity, Male Sex, Chronicity, Meniscus Injury And Posterior Tibial Slope Are Associated With A High-Grade Pre-Operative Pivot Shift: A Post Hoc Analysis Of The Stability Study Abstract Presentation 6 minutes Lachlan Batty, FRACS, AUSTRALIA Andrew Firth, PhD, CANADA Gilbert Moatshe, MD, PhD, NORWAY Dianne M. Bryant, PhD, CANADA S. Mark A. Heard, MD, FRCS, CANADA Robert G. McCormack, MD, CANADA Alex Rezansoff, MD, FRCSC, CANADA Devin Clarke Peterson, MD, FRCSC, Dip Sport Med, CANADA Davide Bardana, MD, CANADA Peter B. MacDonald, MD, FRCS, Dip Sport Med, CANADA Tim Spalding, FRCS(Orth), UNITED KINGDOM Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
In Vivo Measurement of Anterior Cruciate Ligament Elongation and Strain Rate during Increasingly Demanding Activities ePoster Presentation Kyohei Nishida , MD, PhD, JAPAN Caiqi Xu, MD, CHINA Tom Gale, MS, UNITED STATES William Anderst, PhD, UNITED STATES Freddie H. Fu, MD, UNITED STATES
Nerve injury during anterior cruciate ligament reconstruction: A comparison between patellar and hamstring tendon grafts harvest Abstract Presentation 5 minutes Jonathan Singer, MD, ISRAEL Ehud Rath, Prof., ISRAEL Mustafa Yassin, MD, ISRAEL Shlomo Bronak, MD, ISRAEL Barak Haviv, MD, ISRAEL
Value, Limitations And Recommendations For Use Of Metal-Reduction Knee MRI Sequences Following Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Brandon Zhao, MD, CANADA Nabil Khan, MBChB, MMED, FCS Orth, CANADA Mark F. Sommerfeldt, MD, CANADA Anukul Panu, MD, CANADA Jacob L Jaremko, MD, PhD, CANADA Catherine May Ting Hui, MD, FRCSC, CANADA
Acl - Pcl Fixation Sequence During Multi-Ligament Knee Reconstruction Does Not Affect Knee Laxity Abstract Presentation 6 minutes Carola F. van Eck, MD, PhD, FAAOS, UNITED STATES Aly Maher Fayed, MD, EGYPT Ryo Kanto, MD, JAPAN Taylor M. Price, MS, UNITED STATES Michael Dinenna, BS, UNITED STATES Monica A. Linde, MSIE, RN, UNITED STATES Patrick J. Smolinski, PhD, UNITED STATES
Return To Elite Sport After ACL Reconstruction In 376 'Professional' Athletes Abstract Presentation 5 minutes Kyle Borque, MD, UNITED STATES Mary Jones, MSc, Grad. Dip. Phys., UNITED KINGDOM Ganesh Balendra, MBBS, AUSTRALIA Lukas Willinger, MD, GERMANY Vitor Hugo Pinheiro, MD, UNITED KINGDOM Andy Williams, MBBS, FRCS(Orth), FFSEM(UK), UNITED KINGDOM
Inter- and Intra-Rater Reliability of Measurenebt of ACL TUnnels with Radiographs, CT, and MRI Abstract Presentation 4 minutes Robert A Magnussen, MD, MPH, UNITED STATES Alexander Sparks, BS, UNITED STATES Jacy Leon, BS, UNITED STATES Matthew Colatruglio, BS, UNITED STATES Joshua Bowler, MD James Oosten, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Joshua Scott Everhart, MD, MPH, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES David C. Flanigan, MD, UNITED STATES
PROSPECTIVE RANDOMIZED STUDY: Double-bundle against single-bundle ACL reconstruction using allografts Abstract Presentation 5 minutes Edmundo Berumen Nafarrate, PhD, Prof., MEXICO Carlos Alejandro Vega Najera, MD, MEXICO Joel Alejandro Cabral, MD, MEXICO Jesus Javier Tonche, MD, MEXICO Ivan Ramos Moctezuma, Eng, MEXICO Luis Sigala Gonzalez, Eng, MEXICO Avril Pérez Fontes, MD, MEXICO Fatima Quintana Trejo, Eng, MEXICO Carlos Leal, MD, Prof., COLOMBIA

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PSM: Pivot Shift Meter Cellphone Application for Classifying ACL Injuries

PSM: Pivot Shift Meter Cellphone Application for Classifying ACL Injuries

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PSM: Pivot Shift Meter Cellphone Application for Classifying ACL Injuries

PSM: Pivot Shift Meter Cellphone Application for Classifying ACL Injuries

Background

Hypothesis

Materials And Methods

Results

Conclusions

More ISAKOS 2021: Global Content