Subjective grade of apprehension during the pivot-shift test reflects patient-reported outcomes more than conventional pivot-shift test grade after ACL reconstruction

Nakamae Atsuo

Tsukisaka Kazuhiro

Deie Masataka

Miyamoto Ayato

Eguchi Akio

Kato Tomohiro

Nekomoto Akinori

Adachi Nobuo

Knee Surgery, Sports Traumatology, Arthroscopy

Purpose
To investigate whether the pivot-shift test reflects patient-reported outcomes 1 year after anterior cruciate ligament (ACL) reconstruction based on a multicentre prospective cohort study.
Methods
This study included patients who underwent primary ACL reconstruction using the hamstring tendons. The pivot-shift test grades were determined according to the International Knee Documentation Committee (IKDC) form as 0, 1+, 2+ or 3+. In addition, patients' subjective apprehension during the pivot-shift test were classified as 0 (no-apprehension), 1+ (mild-apprehension), 2+ (moderate-apprehension) or 3+ (severe-apprehension). In this study, a positive pivot-shift test was defined as grade 1+ or higher.
Results
A total of 837 patients were enroled in this study. One year postoperatively, there was no significant difference in the Knee injury and Osteoarthritis Outcome Score (KOOS), IKDC score, Lysholm knee scale and Tegner activity scale between the positive (118 patients) and negative (719 patients) groups of the conventional IKDC grading of the pivot-shift test. However, when divided into two groups based on the apprehension grading of the pivot-shift test after surgery, the postoperative scores were significantly lower in the apprehension-positive group (114 patients) than those in the apprehension-negative group (723 patients) on the Tegner activity scale and KOOS Symptom, Sports/Rec and Quality of Life subscales.
Conclusions
Patients' subjective apprehension during the pivot-shift test after ACL reconstruction was significantly associated with the postoperative Tegner activity scale and three subscales of the KOOS. However, there was no association between the conventional IKDC grading of the pivot-shift test and any patient-reported outcomes postoperatively.

anterior cruciate ligament (ACL)

knee

multicentre study

pivot-shift test

英語

Wiley

© 2024 European Society of Sports Traumatology, Knee Surgery and Arthroscopy.

This is the peer reviewed version of the following article: Nakamae, A., Tsukisaka, K., Deie, M., Miyamoto, A., Eguchi, A., Kato, T. et al. (2024) Subjective grade of apprehension during the pivot-shift test reflects patient-reported outcomes more than conventional pivot-shift test grade after ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy, 1–8, which has been published in final form at https://doi.org/10.1002/ksa.12383. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

This is not the published version. Please cite only the published version.

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[DOI] https://doi.org/10.1002/ksa.12383 ～の異版である

日本学術振興会

Japan Society for the Promotion of Science

[Crossref Funder] https://doi.org/10.13039/501100001691

膝前十字靭帯再建術後の完全なスポーツ復帰を目指した多施設共同研究 研究課題

膝前十字靭帯再建術後の完全なスポーツ復帰を目指した多施設共同研究 研究課題

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