@article {15806, title = {Assessment of Rotatory Laxity in Anterior Cruciate Ligament-Deficient Knees using Magnetic Resonance Imaging with Porto-Knee Testing Device}, journal = {Knee Surgery, Sports Traumatology, Arthroscopy}, volume = {20}, year = {2012}, month = {2012-05-17 00:00:00}, pages = {671-678}, abstract = {

Purpose Objective evaluation of both antero-posterior translation and rotatory laxity of the knee remains a target to be accomplished. This is true for both preoperative planning and postoperative assessment of different ACL reconstruction emerging techniques. The ideal measure- ment tool should be simple, accurate and reproducible, while enabling to assess both {\textquoteleft}{\textquoteleft}anatomy{\textquoteright}{\textquoteright} and {\textquoteleft}{\textquoteleft}function{\textquoteright}{\textquoteright} during the same examination. The purpose of this study is to evaluate the clinical effectiveness of a new in-house- developed testing device, the so-called Porto-knee testing device (PKTD). The PKTD is aimed to be used on the\ 

evaluation of both antero-posterior and rotatory laxity of the knee during MRI exams. Methods Between 2008 and 2010, 33 patients with ACL- deficient knees were enrolled for the purpose of this study. All patients were evaluated in the office and under anesthesia with Lachman test, lateral pivot-shift test and anterior drawer test. All cases were studied preoperatively with KT-1000 and MRI with PKTD, and examinations performed by independent observers blinded for clinical evaluation. During MRI, we have used a PKTD that applies antero-posterior translation and permits free tibial rotation through a standardized pressure (46.7 kPa) in the proximal posterior region of the leg. Measurements were taken for both knees and comparing side-to-side. Five patients with partial ruptures were excluded from the group of 33. Results For the 28 remaining patients, 3 women and 25 men, with mean age of 33.4 {\textpm} 9.4 years, 13 left and 15 right knees were tested. No significant correlation was noticed for Lachman test and PKTD results (n.s.). Pivot-shift had a strong positive correlation with the difference in anterior translation registered in lateral and medial tibia plateaus of injured knees (cor. coefficient = 0.80; p \ 0.05), and with the difference in this parameter as compared to side-to-side (cor. coefficient = 0.83; p \ 0.05).

Considering the KT-1000 difference between injured and healthy knees, a very strong positive correlation was found for side-to-side difference in medial (cor. coeffi- cient = 0.73; p \ 0.05) and lateral (cor. coefficient = 0.5; p \ 0.05) tibial plateau displacement using PKTD. Conclusion The PKTD proved to be a reliable tool in assessment of antero-posterior translation (comparing with KT-1000) and rotatory laxity (compared with lateral pivot- shift under anesthesia) of the ACL-deficient knee during MRI examination.

Level of evidence Therapeutic studies, Level IV.

}, keywords = {Knee, Lachman test, Magnetic resonance imaging associated device, Pivot-shift, Rotatory laxity}, author = {Espregueira-Mendes, J. D. and Pereira, H. and Sevivas, N. and Passos, C. and Vasconcelos, J. C. and Monteiro, A. and Oliveira, J. M. and Reis, R. L.} }