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Patients with high-grade pivot-shift phenomenon are associated with higher prevalence of anterolateral ligament injury after acute anterior cruciate ligament injuries

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To compare the prevalence of concomitant anterolateral ligament (ALL) injury between patients with high-grade (grades II and III) pivot-shift and those with low-grade (grades 0 and I) pivot-shift phenomenon after acute anterior cruciate ligament (ACL) injuries.

Methods

Sixty-eight patients with an acute ACL injury who showed high-grade (grades II and III) pivot-shift phenomenon were enrolled as the study group. They were matched in a 1:1 fashion to another 68 ACL-injured control participants who showed low-grade (grades 0 and I) pivot-shift phenomenon during the same study period. Patients were matched by age, sex, and time from injury to surgery. A standardized pivot-shift test was performed under anesthesia for all the patients. Two blinded musculoskeletal radiologists reviewed the magnetic resonance imaging (MRI) scans for the presence of concomitant ALL injury. The grade of an ALL injury was divided into grade 0 (normal), grade I (sprain), grade II (partial tear), and grade III (complete tear). The prevalence and the grade of concomitant ALL injury were further compared between the study group and the control group.

Results

Overall, the prevalence of concomitant ALL injury in the study group (94.1%, 64/68) was significantly higher than that in the control group [60.3%, (41/68), P < 0.05]. Specifically, there were 49 patients (49/64, 76.6%) who showed grade II/III (partial/complete tear) MRI evidence of concomitant ALL injury, which was also significantly higher than that in the control group (12/41, 29.3%).

Conclusions

Patients with high-grade pivot-shift phenomenon showed higher prevalence of concomitant ALL injury compared to those with low-grade pivot-shift phenomenon after acute ACL injuries. Careful assessment and proper treatment of this concomitant injury should be considered especially in knees with high-grade pivot-shift phenomenon.

Level of evidence

III.

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Authors and Affiliations

  1. Sports Medicine Service, Beijing Jishuitan Hospital, No. 31, Xin Jie Kou East Street, Xi Cheng District, Beijing, China

    Guan-yang Song, Hui Zhang, Guan Wu, Jin Zhang, Xin Liu, Zhe Xue, Yi Qian & Hua Feng

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  1. Guan-yang Song
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  2. Hui Zhang
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  3. Guan Wu
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  4. Jin Zhang
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  5. Xin Liu
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  6. Zhe Xue
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  7. Yi Qian
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  8. Hua Feng
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Corresponding author

Correspondence to Hua Feng.

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Conflict of interest

GYS and HF have received funding from the National Natural Science Foundation of China (81572153). GW has received funding from the Beijing Municipal Science and Technology Commission (Z161100000516049).

Ethical standards

This study was performed strictly compliant with the ethical standards.

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Cite this article

Song, Gy., Zhang, H., Wu, G. et al. Patients with high-grade pivot-shift phenomenon are associated with higher prevalence of anterolateral ligament injury after acute anterior cruciate ligament injuries. Knee Surg Sports Traumatol Arthrosc 25, 1111–1116 (2017). https://doi.org/10.1007/s00167-017-4492-z

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  • DOI: https://doi.org/10.1007/s00167-017-4492-z

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