Individualized ACL reconstruction

Paulo H. Araujo, Mauricio Kfuri Junior, Bruno Ohashi, Yuichi Hoshino, Stephano Zaffagnini, Kristian Samuelsson, Jon Karlsson, Freddie Fu, Volker Musahl

Research output: Contribution to journalArticlepeer-review


The pivot shift test is the only physical examination test capable of predicting knee function and osteoarthritis development after an ACL injury. However, because interpretation and performance of the pivot shift are subjective in nature, the validity of the pivot shift is criticized for not providing objective information for a complete surgical planning for the treatment of rotatory knee laxity. The aim of ACL reconstruction was eliminating the pivot shift sign. Many structures and anatomical characteristics can influence the grading of the pivot shift test and are involved in the genesis and magnitude of rotatory instability after an ACL injury. The objective quantification of the pivot shift may be able to categorize knee laxity and provide adequate information on which structures are affected besides the ACL. A new algorithm for rotational instability treatment is presented, accounting for patients’ unique anatomical characteristics and objective measurement of the pivot shift sign allowing for an individualized surgical treatment. Level of evidence V.

Original languageEnglish
Pages (from-to)1966-1975
Number of pages10
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Issue number9
Publication statusPublished - Sep 1 2014


  • ACL reconstruction
  • Anterior cruciate ligament
  • Clinical examination
  • Individualized ACL reconstruction
  • Physical examination
  • Pivot shift
  • Rotatory laxity
  • Treatment

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery
  • Medicine(all)


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