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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Acl Deficiency Influences Medio-Lateral Tibial Alignment And Knee Varus–Valgus During In Vivo Activities Abstract Presentation 3 minutes Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, ITALY Alberto Grassi, PhD, ITALY Marco Bontempi, ITALY Erika Pinelli, MsC, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY
Does In Vivo Kinematics Following Acl Reconstruction With Or Without Lateral Extraarticular Tenodesis Correlate With Preoperative Quantitative Pivot Shift? Abstract Presentation 5 minutes Christopher M. Gibbs, MD, UNITED STATES Philipp Wilhelm Winkler, MD, AUSTRIA Jonathan D Hughes, MD, UNITED STATES Adam Popchak, DPT, PhD, UNITED STATES Daisuke Chiba, MD, PhD, JAPAN Bryson P. Lesniak, MD, UNITED STATES William Anderst, PhD, UNITED STATES Volker Musahl, MD, Prof., UNITED STATES
Adding A Lateral Extra-Articular Tenodesis Significantly Reduces Acl Graft Rupture Rates In Pediatric And Adolescent Patients When Compared To Isolated Acl Reconstruction Abstract Presentation 5 minutes Andrea Ferretti, Prof., ITALY Adnan Saithna, MD, FRCS, UNITED STATES Alessandro Carrozzo, MD, ITALY Alessandro Annibaldi, MD, ITALY Fabio Marzilli, MD, ITALY Edoardo Monaco, MD, ITALY
MRI After ACL Reconstruction Demonstrates that Hamstring Grafts Heal and Integrate at Different Rates Abstract Presentation 6 minutes Sven Edward Putnis, MB ChB FRCS(Tr&Orth), UNITED KINGDOM Takeshi Oshima, MD, PhD, JAPAN Antonio Klasan, MD, AUSTRIA Samuel Grasso, PhD, B. Engineering (Mechanical), AUSTRALIA Thomas Neri, MD, PhD, Prof., FRANCE Myles R. J. Coolican, FRACS, AUSTRALIA Brett A. Fritsch, MBBS BSc(Med), FRACS, FAOrthA, AUSTRALIA David A. Parker, MBBS, BMedSc, FRACS, AUSTRALIA
Age, Time From Injury To Surgery And Quadriceps Strength Affect The Risk Of Revision Surgery After Primary Acl Reconstruction Abstract Presentation 6 minutes Riccardo Cristiani, MD, PhD, SWEDEN Magnus Forssblad, SWEDEN Gunnar Edman, MD, PhD, Prof., SWEDEN Karl Eriksson, MD, PhD, Prof., SWEDEN Anders Stalman, MD, PhD, associate professor, SWEDEN
Factors associated with anterior cruciate ligament (ACL) reconstruction among ACL injuries in Alberta, Canada ePoster Presentation Yuba Raj Paudel, MPH, CANADA Mark F. Sommerfeldt, MD, CANADA Donald C. Voaklander, PhD, CANADA
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
Negative Effects Of Delayed Anterior Cruciate Ligament Reconstruction On Associated Injuries And Knee Laxity Abstract Presentation 6 minutes Riccardo Cristiani, MD, PhD, SWEDEN Per-Mats Janarv, MD, Assist. Prof., SWEDEN Bjorn Engstrom, MD, PhD, Assoc. Prof., SWEDEN Gunnar Edman, MD, PhD, Prof., SWEDEN Magnus Forssblad, SWEDEN Anders Stalman, MD, PhD, associate professor, SWEDEN

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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