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|Title:||Is the KiRA device useful in quantifying the pivot shift in anterior cruciate ligament-deficient knees?|
|Epworth Authors:||Feller, Julian|
|Other Authors:||Napier, Richard|
|Keywords:||Kinematic Rapid Assessment|
Anterior Cruciate Ligament
Unilateral ACL Reconstruction
Range of Acceleration
Slope of Acceleration
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
|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.|
|Journal Title:||Orthopaedic Journal of Sports Medicine|
|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|
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