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Medientyp:
E-Artikel
Titel:
Is the KiRA Device Useful in Quantifying the Pivot Shift in Anterior Cruciate Ligament–Deficient Knees?
Beteiligte:
Napier, Richard J.;
Feller, Julian A.;
Devitt, Brian M.;
McClelland, Jodie A.;
Webster, Kate E.;
Thrush, Ciaran S.J.;
Whitehead, Timothy S.
Erschienen:
SAGE Publications, 2021
Erschienen in:Orthopaedic Journal of Sports Medicine
Beschreibung:
<jats:sec><jats:title>Background:</jats:title><jats:p> Various technologies have been developed to quantify the pivot shift, as it is regarded as a key indicator of anterolateral rotatory laxity of the knee. </jats:p></jats:sec><jats:sec><jats:title>Purpose:</jats:title><jats:p> To determine the usefulness of a commercially available triaxial accelerometer (Kinematic Rapid Assessment [KiRA]) in numerically quantifying the pivot shift in patients under anesthesia with an anterior cruciate ligament (ACL)–deficient knee. </jats:p></jats:sec><jats:sec><jats:title>Study Design:</jats:title><jats:p> Cohort study (diagnosis); Level of evidence, 3. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> Both knees of 50 patients (26 male [mean age, 30.4 years], 24 female [mean age, 26.6 years]) under anesthesia were assessed immediately before unilateral ACL reconstruction by an orthopaedic fellow and 1 of 3 experienced knee surgeons. The pivot-shift grade and 2 KiRA outputs (range of acceleration and slope of acceleration change) were compared. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The surgeon and fellow recorded the same pivot-shift grade for 45 of 50 patients (90%). Data from the 5 patients with no agreement and 1 patient with extreme outlying data were excluded from subsequent analysis. Using the KiRA range and slope data, the surgeon identified the injured knee in 74% and 76% of patients, respectively, while the fellow’s rate of injured knee identification was 74% and 80%, respectively. A correlation could be found only between pivot-shift grade and surgeon-derived range data ( ρ = 0.40; P < .01) but not slope data or any fellow-derived outputs. Using the surgeon-derived range data, there was a significant difference between a grade 3 pivot (>5 m/s<jats:sup>2</jats:sup>) and a grade 1 or 2 pivot (<5 m/s<jats:sup>2</jats:sup>) ( P = .01). </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Although a correlation between KiRA output data and pivot-shift grade was found when the device was used by an experienced surgeon, there was no correlation when used by a well-trained but less experienced orthopaedic fellow. Furthermore, the KiRA output data identified the ACL-deficient knee correctly in only 74% of patients. Although a threshold acceleration range value could be identified, above which the value was associated with a grade 3 pivot shift, this was dependent on the examiner, and distinction between other grades could not be made. </jats:p></jats:sec>