Intraoperative pivot-shift accelerometry combined with anesthesia improves the measure of rotatory knee instability in anterior cruciate ligament injury

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dc.article.number80
dc.contributor.authorCaracciolo, Gastón
dc.contributor.authorYáñez, Roberto
dc.contributor.authorSilvestre, Rony
dc.contributor.authorDe la Fuente, Carlos
dc.contributor.authorZamorano, Héctor
dc.contributor.authorOssio, Alejandra
dc.contributor.authorStrömbäck, Lars
dc.contributor.authorAbusleme, Sebastian
dc.contributor.authorP. Carpes, Felipe
dc.date.accessioned2021-10-13T16:09:20Z
dc.date.available2021-10-13T16:09:20Z
dc.date.issued2021
dc.date.updated2021-09-26T00:02:12Z
dc.description.abstractPurpose: The knee stifness acquired following an Anterior Cruciate Ligament (ACL) injury might afect clinical knee tests, i.e., the pivot-shift maneuver. In contrast, the motor efects of spinal anesthesia could favor the identifcation of rotatory knee defciencies prior to ACL reconstruction. Hence, we hypothesized that the intra-operative pivot-shift maneuver under spinal anesthesia generates more acceleration in the lateral tibial plateau of patients with an injured ACL than without. Methods: Seventy patients with unilateral and acute ACL rupture (62 men and 8 women, IKDC of 55.1±13.8 pts) were assessed using the pivot-shift maneuver before and after receiving spinal anesthesia. A triaxial accelerometer was attached to the skin between Gerdys’ tubercle and the anterior tuberosity to measure the subluxation and reduction phases. Mixed ANOVA and multiple comparisons were performed considering the anesthesia and leg as factors (alpha=5%). Results: We found a higher acceleration in the injured leg measured under anesthesia compared to without anesthesia (5.12±1.56m.s−2 vs. 2.73±1.19m.s−2 , p<0.001), and compared to the non-injured leg (5.12±1.56m.s−2 vs. 3.45±1.35m.s−2 , p<0.001). There was a presence of signifcant interaction between leg and anesthesia conditions (p<0.001). Conclusions: The pivot-shift maneuver performed under anesthesia identifes better rotatory instability than without anesthesia because testing the pivot-shift without anesthesia underestimates the rotatory subluxation of the knee by an increased knee stifness. Thus, testing under anesthesia provides a unique opportunity to determine the rotational instability prior to ACL reconstruction.
dc.format.extent7 páginas
dc.fuente.origenAutoarchivo
dc.identifier.citationJournal of Experimental Orthopaedics. 2021 Sep 24;8(1):80
dc.identifier.doi10.1186/s40634-021-00396-1
dc.identifier.urihttps://doi.org/10.1186/s40634-021-00396-1
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/62810
dc.information.autorucEscuela de Medicina ; De la Fuente, Carlos ; 0000-0002-2429-837X ; 1013851
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final7
dc.pagina.inicio1
dc.revistaJournal of Experimental Orthopaedics
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.subjectJoint laxityes_ES
dc.subjectJoint stabilityes_ES
dc.subjectLigamentses_ES
dc.subjectKinematicses_ES
dc.subjectLower extremityes_ES
dc.subjectRupturees_ES
dc.subject.ddc616.7
dc.subject.deweyMedicina y saludes_ES
dc.titleIntraoperative pivot-shift accelerometry combined with anesthesia improves the measure of rotatory knee instability in anterior cruciate ligament injuryes_ES
dc.typeartículo
dc.volumen8
sipa.codpersvinculados1013851
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