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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(01): e82-e87
DOI: 10.1055/s-0044-1779316
Artigo Original
Joelho

Must a Knee with Anterior Cruciate Ligament Deficiency and High-grade Pivot Shift Test Present an Increase in Internal Rotation?[*]

Article in several languages: português | English
Luiz Henrique Pires de Lima 
1   Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
,
João Luiz Ellera Gomes 
1   Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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Abstract

Objective: Rupture of the anterior cruciate ligament (ACL) is one of the most common injuries in athletes and is often associated with damage to anterolateral structures. This combination of injuries presents itself clinically as a high-grade pivot shift test. The hypothesis of this study is that patients with ACL deficiency and high-grade pivot shift test should have an increased internal knee rotation.

Methods: Twenty-two patients were tested. After effective spinal anesthesia, two tests were performed with the patient in supine position. First, the bilateral pivot shift test was performed manually, and its grade was recorded. Then, with the knee flexed to 90 degrees, the examiner drew the projection of the foot in a neutral position and in maximum internal rotation, and the angle of internal rotation was measured from the axes built between the central point of the heel and the hallux.

Results: In the ACL-deficient knee, it was observed that there is a statistically significant average internal rotation (IR) delta of 10.5 degrees between the groups when not adjusted for age, and 10.6 degrees when adjusted for age.

Conclusions: Knees with ACL deficiency and with pivot shift test grade I do not show increased internal rotation in relation to knees with intact ACL. Knees with ACL deficiency and with pivot shift test grades II and III show increased internal rotation in comparison to healthy knees.

Keywords

anterior cruciate ligament - joint instability - biomechanical phenomena

* Work developed at the Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.




Publication History

Received: 16 November 2022

Accepted: 29 May 2023

Article published online:
21 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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