Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, 1981, Kamoda, Kawagoe, Saitama, 350-8550, Japan.
Knee Surg Sports Traumatol Arthrosc. 2011 Apr;19(4):572-8. doi: 10.1007/s00167-010-1279-x. Epub 2010 Oct 2.
The gravity-assisted pivot-shift (GAPS) test is a newly advocated test for anterior cruciate ligament (ACL) injury. We retrospectively investigated the relationships between the result of preoperative GAPS test and the function of the reconstructed ACL using autogenous hamstring tendon grafts.
Seventy-eight patients with unilateral ACL injury and a minimum of 1-year follow-up were enrolled in this study. According to the result of preoperative GAPS test, they were divided into two groups, i.e., positive test group (Group P) and negative test group (Group N). At the time of follow-up, the operated knee was examined manually and using KT-1000 arthrometer. According to these results, the function of the reconstructed ACL was classified.
The proportion of the knees with a negative abnormal laxity test was less in Group P than Group N with the significant difference in Lachman test (P = 0.0029) and N-test (P = 0.0081). The proportion of the cases having greater than 3 mm of the side-to-side difference in anterior knee laxity using KT-1000 arthrometer was greater in Group P, in spite of no statistically significant difference. Regarding the classification of the function of the reconstructed ACL, Group P was worse than Group N (P = 0.0187), and all 4 knees classified as failed belonged to Group P.
The knees with a preoperative positive GAPS test showed worse postoperative function of the reconstructed ACL than those with a negative test. Preoperative positive GAPS test is considered to be a predisposing factor to poor functional outcome after ACL reconstruction. It is possible that the use of hamstring tendons as a graft source should be avoided for the ACL-injured patients with a positive GAPS test.
重力辅助枢轴转移（GAPS）试验是一种新提出的用于前交叉韧带（ACL）损伤的试验。我们回顾性研究了使用自体腘绳肌腱移植物重建 ACL 前后 GAPS 试验结果与 ACL 功能之间的关系。
本研究纳入了 78 例单侧 ACL 损伤患者，随访时间至少 1 年。根据术前 GAPS 试验结果，将患者分为阳性试验组（GAPSP 组）和阴性试验组（GAPSN 组）。在随访时，对手术膝关节进行手动和 KT-1000 关节仪检查。根据这些结果，对重建 ACL 的功能进行分类。
与 GAPSN 组相比，GAPSP 组的阴性异常松弛试验膝关节比例较低，Lachman 试验（P=0.0029）和 N 试验（P=0.0081）的差异有统计学意义。使用 KT-1000 关节仪测量时，前膝松弛度的侧间差异大于 3mm 的病例比例在 GAPSP 组中更高，但差异无统计学意义。在重建 ACL 功能的分类方面，GAPSP 组比 GAPSN 组差（P=0.0187），所有 4 例分类为失败的病例均属于 GAPSP 组。
术前 GAPS 试验阳性的膝关节术后重建 ACL 的功能较差。术前 GAPS 试验阳性被认为是 ACL 重建后功能不良的一个潜在因素。对于 GAPS 试验阳性的 ACL 损伤患者，可能应避免使用腘绳肌腱作为移植物来源。
