title: Patients with high-grade pivot-shift phenomenon are associated with higher prevalence of anterolateral ligament injury after acute anterior cruciate ligament injuries.
abstract: OBJECTIVE
  To compare the prevalence of concomitant anterolateral ligament (ALL) injury between patients with high-grade (grades II and III) pivot-shift and those with low-grade (grades 0 and I) pivot-shift phenomenon after acute anterior cruciate ligament (ACL) injuries.
  
  
  METHODS
  Sixty-eight patients with an acute ACL injury who showed high-grade (grades II and III) pivot-shift phenomenon were enrolled as the study group. They were matched in a 1:1 fashion to another 68 ACL-injured control participants who showed low-grade (grades 0 and I) pivot-shift phenomenon during the same study period. Patients were matched by age, sex, and time from injury to surgery. A standardized pivot-shift test was performed under anesthesia for all the patients. Two blinded musculoskeletal radiologists reviewed the magnetic resonance imaging (MRI) scans for the presence of concomitant ALL injury. The grade of an ALL injury was divided into grade 0 (normal), grade I (sprain), grade II (partial tear), and grade III (complete tear). The prevalence and the grade of concomitant ALL injury were further compared between the study group and the control group.
  
  
  RESULTS
  Overall, the prevalence of concomitant ALL injury in the study group (94.1%, 64/68) was significantly higher than that in the control group [60.3%, (41/68), P < 0.05]. Specifically, there were 49 patients (49/64, 76.6%) who showed grade II/III (partial/complete tear) MRI evidence of concomitant ALL injury, which was also significantly higher than that in the control group (12/41, 29.3%).
  
  
  CONCLUSIONS
  Patients with high-grade pivot-shift phenomenon showed higher prevalence of concomitant ALL injury compared to those with low-grade pivot-shift phenomenon after acute ACL injuries. Careful assessment and proper treatment of this concomitant injury should be considered especially in knees with high-grade pivot-shift phenomenon.
  
  
  METHODS
  III.
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, No. 31, Xin Jie Kou East Street, Xi Cheng District, Beijing, China.
authors.forename: Guan-Yang
authors.initials: GY
authors.lastname: Song
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, No. 31, Xin Jie Kou East Street, Xi Cheng District, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, No. 31, Xin Jie Kou East Street, Xi Cheng District, Beijing, China.
authors.forename: Guan
authors.initials: G
authors.lastname: Wu
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, No. 31, Xin Jie Kou East Street, Xi Cheng District, Beijing, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, No. 31, Xin Jie Kou East Street, Xi Cheng District, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Liu
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, No. 31, Xin Jie Kou East Street, Xi Cheng District, Beijing, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Xue
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, No. 31, Xin Jie Kou East Street, Xi Cheng District, Beijing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Qian
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, No. 31, Xin Jie Kou East Street, Xi Cheng District, Beijing, China. fenghua20080617@126.com.
authors.forename: Hua
authors.initials: H
authors.lastname: Feng
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000145:classification / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology; D007718:Knee Injuries / Q000145:classification / Q000000981:diagnostic imaging / Q000503:physiopathology; D008023:Ligaments, Articular / Q000000981:diagnostic imaging* / Q000293:injuries / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies
keywords: Acute anterior cruciate ligament injury; Anterolateral ligament injury; High-grade pivot shift; Low-grade pivot shift; Magnetic resonance imaging