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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Risk Factors for Grade 3 Pivot Shift in Acute ACL-Injured Knees Abstract Presentation 5 minutes Adnan Saithna, MD, FRCS, UNITED STATES Edoardo Monaco, MD, ITALY Edoardo Gaj, MD, ITALY Valerio Andreozzi, ITALY Alessandro Annibaldi, MD, ITALY Alessandro Carrozzo, MD, ITALY Thais Dutra Vieira, MD, FRANCE Bertrand Sonnery-Cottet, MD, PhD, FRANCE Andrea Ferretti, Prof., ITALY
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The Effect of Lateral Extra-Articular Tenodesis on Medial and Lateral Menisci Loading in Response To Simulated Tests of the Pivot Shift and Anterior Laxity Abstract Presentation 6 minutes Niv Marom, MD, ISRAEL Hamid Jahandar, BS, UNITED STATES Zaid Zayyad, MD, MS, UNITED STATES thomas fraychineaud, MD, UNITED STATES Herve Ouanezar, MD, UNITED ARAB EMIRATES Ronak M. Patel, MD, UNITED STATES Carl W Imhauser, PhD, UNITED STATES Thomas L. Wickiewicz, MD, UNITED STATES Andrew D. Pearle, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
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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
The Outcome Of Non-circular (Rectangle, Oval) Femoral Tunnel ACL Reconstruction, Does It Improve The Outcome Of ACL Reconstruction Surgery? Abstract Presentation 6 minutes S. Ali Ghasemi, MD, UNITED STATES Joseph McCahon, DO, UNITED STATES Arthur R Bartolozzi, MD, UNITED STATES
Combined ACL and Anterolateral Ligament Reconstruction Confers Significantly Improved Long Term Outcomes when Compared to Isolated ACL Reconstruction: A Matched-Pair Analysis Abstract Presentation 5 minutes Adnan Saithna, MD, FRCS, UNITED STATES Ibrahim Haidar, MD, LEBANON Johnny Rayes, MD, MSc, FEBOT, CANADA Thomas Fradin, MD, FRANCE Cédric Ngbilo, MD, SWITZERLAND Benjamin Freychet, MD, FRANCE Thais Dutra Vieira, MD, FRANCE Herve Ouanezar, MD, UNITED ARAB EMIRATES Bertrand Sonnery-Cottet, MD, PhD, FRANCE
THE OUTCOME OF BALANCE EXERCISES AND AGILITY TRAINING FOR POST ANTERIOR CRUCIATE LIGAMENT (ACL) RECONSTRUCTION: CLINICAL ASSESSMENT Abstract Presentation 7 minutes SITI MAIZATUL AKMAL ISMAIL, Medical Science (Orthopaedic Surgery Sports), MALAYSIA
Predicting Patient Lost to Follow-up in the STABILITY 1 Study: A Multi-centre, International, Randomized Controlled Trial of Young, Active Patients Undergoing Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Andrew Firth, PhD, CANADA Dianne M. Bryant, PhD, CANADA Andrew Johnson, PhD, CANADA Stability Study Group, CANADA Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
Outcomes Following Anterior Cruciate Ligament Reconstruction in Young Patients: An Observational Study. ePoster Presentation Kunal Mohan, MB MCh MRCSI, IRELAND David Cooper, MB MRCSI, IRELAND Niall McGoldrick, MB MCh FRCS (Tr & Orth), IRELAND Martin Davey, MB MCh MRCSI, IRELAND Megan Diack, MBCHB, MRCSI, MCh, IRELAND Paula McQuail, MB FRCSI, IRELAND Fintan J. Shannon, FRCS (Tr/Orth), IRELAND
Quadriceps Tendon Vs. Hamstring Tendon Autograft In Primary Anterior Cruciate Ligament Reconstruction: A Matched-Pairs Study With A Mean Follow-Up Of 6.5 Years Award Winner 5 minutes Armin Runer, PD MD, GERMANY Aline Suter, MD, AUSTRIA Tommaso Roberti di Sarsina, MD, ITALY Caroline Hepperger, PhD, AUSTRIA Peter Gföller, MD, AUSTRIA Christian Hoser, MD, AUSTRIA Robert Csapo, PhD, AUSTRIA Christian Fink, MD, Prof., AUSTRIA
Risk Factor Analysis for Graft Failure after Anterior Cruciate Ligament Reconstruction with or without mLET Abstract Presentation 7 minutes Filip R Hendrikx, MD, BELGIUM Koen Lagae, MD, BELGIUM Annemieke Van Haver, PhD, MSc, BELGIUM Peter Verdonk, MD, PhD, BELGIUM
Same Knee, Different Goals: Patients and Surgeons have Different Priorities Related to ACL Reconstructions and Surgeons are Resistant to Changing Clinical Practice Abstract Presentation 4 minutes Hana Marmura, MPT, PhD, UNITED STATES Dianne M. Bryant, PhD, CANADA Trevor B. Birmingham, PT, PhD, CANADA Kurt Paul Spindler, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Tim Spalding, FRCS(Orth), UNITED KINGDOM Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR

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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