Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction.
BACKGROUND
Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction have not been established.


OBJECTIVE
Relationships exist between objective and subjective assessments after anterior cruciate ligament reconstruction.


METHODS
Case series.


METHODS
Patients (N = 202) undergoing anterior cruciate ligament reconstruction with 2-year minimum follow-up were studied. Objective variables of ligament stability at follow-up included instrumented laxity, Lachman examination, and pivot-shift examination. Subjective variables of symptoms at follow-up included pain, swelling, giving way, locking, crepitus, stiffness, and limping. Subjective function at follow-up included walking, squatting, stair climbing, running, cutting, jumping, twisting, activity limitation, sports level, activities of daily living level, work level, knee function, sports participation, Lysholm score, and satisfaction with outcome.


RESULTS
Instrumented knee laxity and Lachman examination had no significant (P >.05) relationships with any subjective variables of symptoms and function. Pivot-shift examination had significant associations with satisfaction (P =.03), partial giving way (P =.01), full giving way (P =.01), difficulty cutting (P =.01), difficulty twisting (P =.01), activity limitation (P =.01), overall knee function (P =.03), sports participation (P =.02), and Lysholm score (P =.01).


CONCLUSIONS
The pivot-shift examination may be a better measure of "functional instability" than instrumented knee laxity or Lachman examination after anterior cruciate ligament reconstruction.
Kocher
Mininder S
MS
Steadman Hawkins Sports Medicine Foundation, Vail, Colorado, USA. mininder.kocher@children.harvard.edu
Steadman
J Richard
JR
Briggs
Karen K
KK
Sterett
William I
WI
Hawkins
Richard J
RJ
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016059:Range of Motion, Articular / Q000502:physiology