title: Individualized ACL reconstruction.
abstract: The pivot shift test is the only physical examination test capable of predicting knee function and osteoarthritis development after an ACL injury. However, because interpretation and performance of the pivot shift are subjective in nature, the validity of the pivot shift is criticized for not providing objective information for a complete surgical planning for the treatment of rotatory knee laxity. The aim of ACL reconstruction was eliminating the pivot shift sign. Many structures and anatomical characteristics can influence the grading of the pivot shift test and are involved in the genesis and magnitude of rotatory instability after an ACL injury. The objective quantification of the pivot shift may be able to categorize knee laxity and provide adequate information on which structures are affected besides the ACL. A new algorithm for rotational instability treatment is presented, accounting for patients' unique anatomical characteristics and objective measurement of the pivot shift sign allowing for an individualized surgical treatment.
  
  
  METHODS
  V.
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation of Locomotor System - Ribeirao Preto Medical School, São Paulo University, Av. Bandeirantes, 3900 - Monte Alegre, Ribeirão Prêto, CEP 14049-900, SP, Brazil, pauloaraujo@hotmail.com.
authors.forename: Paulo H
authors.initials: PH
authors.lastname: Araujo
authors.forename: Mauricio
authors.initials: M
authors.lastname: Kfuri Junior
authors.forename: Bruno
authors.initials: B
authors.lastname: Ohashi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hoshino
authors.forename: Stephano
authors.initials: S
authors.lastname: Zaffagnini
authors.forename: Kristian
authors.initials: K
authors.lastname: Samuelsson
authors.forename: Jon
authors.initials: J
authors.lastname: Karlsson
authors.forename: Freddie
authors.initials: F
authors.lastname: Fu
authors.forename: Volker
authors.initials: V
authors.lastname: Musahl
mesh_terms: D000465:Algorithms; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001696:Biomechanical Phenomena; D003936:Diagnosis, Computer-Assisted; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007593:Joint Instability / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D007718:Knee Injuries / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000150:complications / Q000175:diagnosis / Q000209:etiology; D010808:Physical Examination; D011237:Predictive Value of Tests; D016059:Range of Motion, Articular; D012399:Rotation