A pivot shift is a useful exam for evaluating anterior cruciate ligament (ACL) reconstruction surgery. A positive result is a perceived “clunk” and is quantified by the kinematics that occur during the tibial reduction phase. In vitro evaluation of ACL reconstruction techniques includes robotic testing of cadaveric knees where the applied loads represent estimated in situ loads. Early understanding of the mechanism of the pivot shift has resulted in a simplified representation where static “rotary loads” (10Nm valgus torque, 5Nm internal tibial torque) are applied at a few discrete flexion angles, and changes in anterior tibial translation (ATT) are compared . Building upon this work, and with advances in technology, we are now able to create a robotic test that is more like the clinical exam. Our hypothesis was that kinematics produced during the robotically simulated pivot shift would be similar to the clinical pivot shift but would be significantly different from the rotary loads method. The ability for a test to produce larger kinematic differences between native and deficient states may suggest a more robust methodology by which to evaluate the efficacy of ACL reconstructions.
- Bioengineering Division
Robotically Simulated Clinical Pivot Shift: A Better Tool for Analyzing ACL Reconstructions?
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Colbrunn, RW, Dumpe, JE, Bonner, TF, Kolmodin, JD, Barsoum, WK, & Saluan, PM. "Robotically Simulated Clinical Pivot Shift: A Better Tool for Analyzing ACL Reconstructions?." Proceedings of the ASME 2013 Summer Bioengineering Conference. Volume 1B: Extremity; Fluid Mechanics; Gait; Growth, Remodeling, and Repair; Heart Valves; Injury Biomechanics; Mechanotransduction and Sub-Cellular Biophysics; MultiScale Biotransport; Muscle, Tendon and Ligament; Musculoskeletal Devices; Multiscale Mechanics; Thermal Medicine; Ocular Biomechanics; Pediatric Hemodynamics; Pericellular Phenomena; Tissue Mechanics; Biotransport Design and Devices; Spine; Stent Device Hemodynamics; Vascular Solid Mechanics; Student Paper and Design Competitions. Sunriver, Oregon, USA. June 26–29, 2013. V01BT23A007. ASME. https://doi.org/10.1115/SBC2013-14288
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