Can the pivot-shift be eliminated by anatomic double-bundle anterior cruciate ligament reconstruction?

Stefano Zaffagnini, Giulio Maria Marcheggiani Muccioli, Nicola Lopomo, Cecilia Signorelli, Tommaso Bonanzinga, Costanza Musiani, Papakonstantinou Vassilis, Marco Nitri, Maurilio Marcacci

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To assess the ability of anatomic double-bundle anterior cruciate ligament reconstruction in eliminating the pivot-shift phenomenon when identified by a quantitative measuring system (computer navigation or magnetic resonance imaging). Methods: Literature review. Medline, Google Scholar and Cochrane Reviews computerized databases research using the keywords "pivot-shift," "anterior cruciate ligament reconstruction" and "double bundle." Twelve (7 in vitro and 5 in vivo) studies met the inclusion criteria. Results: There was a wide variation in the absolute value of translation and rotation measured after anatomic double-bundle anterior cruciate ligament reconstruction. There were also differences in fixation methods, pivot-shift execution conditions, applied stresses during the pivot-shift, calculation methods and reference systems utilized by measurement systems. Conclusions: The double-bundle reconstruction was shown to over-constrain the knee with respect to the intact value, especially closer to knee extension. This review demonstrated that anatomic double-bundle anterior cruciate ligament reconstruction is able to eliminate pathological translations and rotations during the pivot-shift phenomenon, as identified by quantitative measurement systems. Level of evidence: Review of Level III studies, Level III.

Original languageEnglish
Pages (from-to)743-751
Number of pages9
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume20
Issue number4
DOIs
Publication statusPublished - Apr 2012

Keywords

  • Anatomic
  • Anterior cruciate ligament
  • Double-bundle
  • Pivot-shift
  • Quantitative assessment

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

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