title: Can the pivot-shift be eliminated by anatomic double-bundle anterior cruciate ligament reconstruction?
abstract: OBJECTIVE
  To assess the ability of anatomic double-bundle anterior cruciate ligament reconstruction in eliminating the pivot-shift phenomenon when identified by a quantitative measuring system (computer navigation or magnetic resonance imaging).
  
  
  METHODS
  Literature review. Medline, Google Scholar and Cochrane Reviews computerized databases research using the keywords "pivot-shift," "anterior cruciate ligament reconstruction" and "double bundle." Twelve (7 in vitro and 5 in vivo) studies met the inclusion criteria.
  
  
  RESULTS
  There was a wide variation in the absolute value of translation and rotation measured after anatomic double-bundle anterior cruciate ligament reconstruction. There were also differences in fixation methods, pivot-shift execution conditions, applied stresses during the pivot-shift, calculation methods and reference systems utilized by measurement systems.
  
  
  CONCLUSIONS
  The double-bundle reconstruction was shown to over-constrain the knee with respect to the intact value, especially closer to knee extension. This review demonstrated that anatomic double-bundle anterior cruciate ligament reconstruction is able to eliminate pathological translations and rotations during the pivot-shift phenomenon, as identified by quantitative measurement systems.
  
  
  METHODS
  Review of Level III studies, Level III.
authors.affiliation: 3rd Orthopaedic and Traumatology Clinic and Biomechanics Laboratory, Codivilla-Putti Research Center, Istituto Ortopedico Rizzoli-University of Bologna, via di Barbiano, 1/10, 40100 Bologna, Italy. s.zaffagnini@biomec.ior.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Zaffagnini
authors.forename: Giulio Maria
authors.initials: GM
authors.lastname: Marcheggiani Muccioli
authors.forename: Nicola
authors.initials: N
authors.lastname: Lopomo
authors.forename: Cecilia
authors.initials: C
authors.lastname: Signorelli
authors.forename: Tommaso
authors.initials: T
authors.lastname: Bonanzinga
authors.forename: Costanza
authors.initials: C
authors.lastname: Musiani
authors.forename: Papakonstantinou
authors.initials: P
authors.lastname: Vassilis
authors.forename: Marco
authors.initials: M
authors.lastname: Nitri
authors.forename: Maurilio
authors.initials: M
authors.lastname: Marcacci
mesh_terms: D000054:Acceleration; D000818:Animals; D016118:Anterior Cruciate Ligament / Q000033:anatomy & histology* / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001696:Biomechanical Phenomena; D015331:Cohort Studies; D004195:Disease Models, Animal; D005069:Evaluation Studies as Topic; D006801:Humans; D066298:In Vitro Techniques; D007593:Joint Instability / Q000517:prevention & control / Q000601:surgery*; D007718:Knee Injuries / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D010808:Physical Examination / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012399:Rotation; D016896:Treatment Outcome