Background: The knee joint is frequently involved in sports and other injuries with Anterior cruciate ligament being a very common ligament to be injured. The Lachman test, pivot-shift test, and instrumented knee laxity examination are frequently used and reported for evaluation of ACL reconstruction. The aim of this study is to examine and evaluate the relationships between the clinical assessment of ligament stability and subjective assessment of symptoms and function after ACL reconstruction.
Methods: A total of 50 young and middle aged patients with unilateral knee ACL injury treated with ACL reconstruction using hamstring graft were evaluated for a minimum period of 1 year. Clinical assessment of ligament stability was done through Lachman and pivot-shift examination. Subjective variables of symptoms at follow-up included pain, swelling, instability and locking of knee. Subjective function at follow up included satisfaction with outcome, squatting, ascending or descending stairs, jumping, twisting and Lysholm score.
Results: Lachman Examination at follow-up had no significant (P > .05) relationship with pain, swelling, instability, locking, squatting, ascending or descending stairs, jumping, twisting, satisfaction with outcome and Lysholm score. Pivot-shift examination at follow-up had significant associations with patient satisfaction (P = .04), instability of knee (P = .02), difficulty during twisting (P = .02) and Lysholm score (P = .01).
Conclusion: Pivot-shift examination is a better measure than Lachman examination or instrumented knee laxity as far as patients' functional outcome and overall satisfaction is concerned.
Keywords: Anterior cruciate ligament (ACL); Functional outcome; Impairment; Lachman test; Ligament stability; Pivot shift test.
Relationships Between Objective Assessment of Ligament Stability and Subjective Assessment of Symptoms and Function After Anterior Cruciate Ligament ReconstructionMS Kocher et al. Am J Sports Med 32 (3), 629-34. PMID 15090377.The pivot-shift examination may be a better measure of "functional instability" than instrumented knee laxity or Lachman examination after anterior cruciate ligament reco …
Determinants of Patient Satisfaction With Outcome After Anterior Cruciate Ligament ReconstructionMS Kocher et al. J Bone Joint Surg Am 84 (9), 1560-72. PMID 12208912.Univariate and multivariate determinants of patient satisfaction with the outcome after reconstruction of the anterior cruciate ligament were established. Although some s …
Effects of Pre-Operative Knee Laxity on Clinical Outcomes After Partial Anterior Cruciate Ligament ReconstructionB Li et al. Knee 25 (3), 445-452. PMID 29685502.In the patients with partial ACL rupture, the mechanical strength of the remnant ligament has significant influence on the therapeutic effects of partial reconstruction. …
The Importance of Patient Sex in the Outcomes of Anterior Cruciate Ligament Reconstructions: A Systematic Review and Meta-analysisSH Tan et al. Am J Sports Med 44 (1), 242-54. PMID 25802119. - ReviewThere were comparable or inferior results for females compared with males in all outcomes analyzed. No statistically significant sex difference was identified in most of …
Pivot Shift as an Outcome Measure for ACL Reconstruction: A Systematic ReviewOR Ayeni et al. Knee Surg Sports Traumatol Arthrosc 20 (4), 767-77. PMID 22218828. - ReviewThe pivot shift test is an important test following ACL reconstruction, and it correlates with functional outcomes.