Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan.
Arthroscopy. 2013 Jun;29(6):1053-62. doi: 10.1016/j.arthro.2013.02.012. Epub 2013 Apr 18.
To investigate the biomechanical function of anterior cruciate ligament (ACL) remnants in ACL-deficient knees with both partial and complete tears.
Twenty partial ACL-deficient (group P), 20 complete ACL-deficient (group C), and 40 contralateral ACL-intact knees were examined. The end point during the Lachman test, side-to-side differences of KT-1000 measurements, and the pivot shift test were evaluated. Additionally, the side-to-side difference of anterior tibial translation during the Lachman test and the acceleration during the pivot shift test were calculated using an electromagnetic measurement system (EMS).
The end point was found in 9 patients in group P, whereas it was not detected in group C. In KT-1000 measurements, the mean side-to-side differences were 3.8 ± 2.4 mm in group P and 5.4 ± 2.3 mm in group C. There was a significant difference between these 2 groups (P < .05). In the pivot shift test evaluation in group P, one patient was evaluated as grade 0, 17 patients as grade 1+, and 2 patients as grade 2+. In group C, 10 patients were evaluated as grade 1+, 9 patients as grade 2+, and one patient as grade 3+. Using the EMS, mean side-to-side differences during the Lachman test were 3.1 ± 2.1 mm in group P and 7.2 ± 3.2 mm in group C. The anterior-posterior displacement in group P was significantly less than that in group C (P < .05). In the quantitative pivot shift test, the mean acceleration in the contralateral ACL-intact knees was -632.7 ± 254.5 mm/s(2), whereas it was -1107.5 ± 398.9 mm/s(2) in group P and -1652.2 ± 754.9 mm/s(2) in group C. Significant differences were detected between the 3 knee conditions (P < .05).
The quantitative assessments of knees with partial ACL ruptures during the Lachman test and the pivot shift test using the EMS showed less laxity than did knees with complete ACL tears, whereas their laxity was greater than the contralateral knees with intact ACLs.
Level III, diagnostic study of nonconsecutive patients.
研究前交叉韧带（ACL）不完全撕裂和完全撕裂的 ACL 缺失膝关节中 ACL 残端的生物力学功能。
共检查了 20 例 ACL 部分撕裂（组 P）、20 例 ACL 完全撕裂（组 C）和 40 例对侧 ACL 完整的膝关节。评估 Lachman 试验的终点、KT-1000 测量的侧间差异以及枢轴转移试验。此外，使用电磁测量系统（EMS）计算 Lachman 试验中胫骨前侧平移的侧间差异和枢轴转移试验中的加速度。
组 P 中有 9 例患者出现终点，而组 C 中未发现终点。在 KT-1000 测量中，组 P 的平均侧间差异为 3.8 ± 2.4mm，组 C 为 5.4 ± 2.3mm。两组间有显著差异（P <.05）。在组 P 的枢轴转移试验评估中，1 例患者为 0 级，17 例患者为 1+级，2 例患者为 2+级。在组 C 中，10 例患者为 1+级，9 例患者为 2+级，1 例患者为 3+级。使用 EMS，组 P 中 Lachman 试验的平均侧间差异为 3.1 ± 2.1mm，组 C 为 7.2 ± 3.2mm。组 P 的前后位移明显小于组 C（P <.05）。在定量枢轴转移试验中，对侧 ACL 完整膝关节的平均加速度为-632.7 ± 254.5mm/s（2），组 P 为-1107.5 ± 398.9mm/s（2），组 C 为-1652.2 ± 754.9mm/s（2）。3 种膝关节状况之间存在显著差异（P <.05）。
使用 EMS 对 Lachman 试验和枢轴转移试验中部分 ACL 断裂膝关节进行的定量评估显示，其松弛度小于完全 ACL 撕裂膝关节，但其松弛度大于对侧 ACL 完整膝关节。
III 级，非连续患者的诊断研究。
