Please use this identifier to cite or link to this item:
Title: Is the KiRA device useful in quantifying the pivot shift in anterior cruciate ligament-deficient knees?
Epworth Authors: Feller, Julian
Devitt, Brian
Other Authors: Napier, Richard
McClelland, Jodi
Webster, Kate
Thrush, Ciaran
Whitehead, Timothy
Keywords: Kinematic Rapid Assessment
Anterior Cruciate Ligament
Pivot Shift
Triaxial Accelerometer
Unilateral ACL Reconstruction
Range of Acceleration
Slope of Acceleration
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Jan-2021
Publisher: SAGE Publications Inc
Citation: Orthop J Sports Med . 2021 Jan 22;9(1):2325967120977869
Abstract: Background: Various technologies have been developed to quantify the pivot shift, as it is regarded as a key indicator of anterolateral rotatory laxity of the knee. Purpose: To determine the usefulness of a commercially available triaxial accelerometer (Kinematic Rapid Assessment [KiRA]) in numerically quantifying the pivot shift in patients under anesthesia with an anterior cruciate ligament (ACL)-deficient knee. Study design: Cohort study (diagnosis); Level of evidence, 3. Methods: Both knees of 50 patients (26 male [mean age, 30.4 years], 24 female [mean age, 26.6 years]) under anesthesia were assessed immediately before unilateral ACL reconstruction by an orthopaedic fellow and 1 of 3 experienced knee surgeons. The pivot-shift grade and 2 KiRA outputs (range of acceleration and slope of acceleration change) were compared. Results: The surgeon and fellow recorded the same pivot-shift grade for 45 of 50 patients (90%). Data from the 5 patients with no agreement and 1 patient with extreme outlying data were excluded from subsequent analysis. Using the KiRA range and slope data, the surgeon identified the injured knee in 74% and 76% of patients, respectively, while the fellow's rate of injured knee identification was 74% and 80%, respectively. A correlation could be found only between pivot-shift grade and surgeon-derived range data (ρ = 0.40; P < .01) but not slope data or any fellow-derived outputs. Using the surgeon-derived range data, there was a significant difference between a grade 3 pivot (>5 m/s2) and a grade 1 or 2 pivot (<5 m/s2) (P = .01). Conclusion: Although a correlation between KiRA output data and pivot-shift grade was found when the device was used by an experienced surgeon, there was no correlation when used by a well-trained but less experienced orthopaedic fellow. Furthermore, the KiRA output data identified the ACL-deficient knee correctly in only 74% of patients. Although a threshold acceleration range value could be identified, above which the value was associated with a grade 3 pivot shift, this was dependent on the examiner, and distinction between other grades could not be made.
DOI: 10.1177/2325967120977869
PubMed URL:
ISSN: 2325-9671
Journal Title: Orthopaedic Journal of Sports Medicine
Type: Journal Article
Affiliated Organisations: Orthopaedic Research Unit, Musgrave Park Hospital, Belfast, Northern Ireland.
School of Allied Health, La Trobe University, Melbourne, Australia.
Hawkes Bay Orthopaedic Group, Hastings, New Zealand.
Type of Clinical Study or Trial: Cohort Study
Appears in Collections:Cancer Services

Files in This Item:
There are no files associated with this item.

Items in Epworth are protected by copyright, with all rights reserved, unless otherwise indicated.