轴移试验：前交叉韧带断裂及相关损伤的当前实验方法与临床应用
The Pivot Shift: Current Experimental Methodology and Clinical Utility for Anterior Cruciate Ligament Rupture and Associated Injury.
作者信息
Vaudreuil Nicholas J, Rothrauff Benjamin B, de Sa Darren, Musahl Volker
机构信息
Department of Orthopaedic Surgery, UPMC Rooney Sports Complex, University of Pittsburgh Medical Center, 3200 S. Water St., Pittsburgh, PA, 15203, USA.
出版信息
Curr Rev Musculoskelet Med. 2019 Mar;12(1):41-49. doi: 10.1007/s12178-019-09529-7.
Abstract
PURPOSE OF REVIEW
The purpose of this manuscript is to (1) examine the history, techniques, and methodology behind quantitative pivot shift investigations to date and (2) review the current status of pivot shift research for its clinical utility for management of anterior cruciate ligament (ACL) rupture with associated injuries including the anterolateral complex (ALC).
RECENT FINDINGS
The pivot shift is a useful physical exam maneuver for diagnosis of rotatory instability related to ACL tear. Recent evidence suggests that the pivot shift is multifactorial and can be seen in the presence of ACL tear with concomitant injury to secondary stabilizers or with predisposing anatomical factors. The presence of a pivot shift post-operatively is associated with poorer outcomes after ACL reconstruction. Recent clinical and biomechanical investigations can help guide clinicians in utilizing pivot shift in diagnosis and surgical planning. Further research is needed to clarify optimal management of ALC in addition to ACL injury.
摘要
综述目的
本手稿的目的是：（1）研究迄今为止定量轴移研究背后的历史、技术和方法；（2）回顾轴移研究在临床应用方面的现状，以用于前交叉韧带（ACL）断裂伴包括前外侧复合体（ALC）在内的相关损伤的管理。
最新发现
轴移是诊断与ACL撕裂相关的旋转不稳定的一种有用的体格检查手法。最近的证据表明，轴移是多因素的，在ACL撕裂伴有二级稳定结构损伤或存在易感解剖因素时可见。ACL重建术后出现轴移与较差的预后相关。最近的临床和生物力学研究有助于指导临床医生在诊断和手术规划中利用轴移。除了ACL损伤外，还需要进一步研究以阐明ALC的最佳管理方法
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