Comparison of the PIVOT App and Pivot Shift Test for Assessing Knee Laxity after ACL Injury: Validity and Impact of Thigh Muscle Coactivity.
Background: The pivot shift is an important and widely used orthopaedic test for assessing anterior cruciate ligament (ACL)-deficient (ACL-D) knees. A continuous measure of the pivot shift test may allow for a more objective assessment of ACL laxity. Purpose: To assess the efficacy of a novel iPad a...
| Publicado en: | Orthopaedic Journal of Sports Medicine Vol. 14; no. 8; pp. 1 - 9 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Aug2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=196600671&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 196600671 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 23259671 FUGT jtl: Orthopaedic Journal of Sports Medicine issn: 23259671 maglogo: Y pubinfo: dt: Aug2026 vid: 14 iid: 8 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 196600671 196600671 196600671 10.1177/23259671261469739 196600671 ppf: 1 ppct: 8 formats: tig: atl: Comparison of the PIVOT App and Pivot Shift Test for Assessing Knee Laxity after ACL Injury: Validity and Impact of Thigh Muscle Coactivity. aug: au: Landry, Madison Jordan, Matthew J. Chan, Denise Galarneau, Jean-Michel Pasanen, Kati Musahl, Volker Mohtadi, Nicholas affil: University of Calgary Sport Medicine Centre, Calgary, Alberta, Canada sug: subj: Mobile Applications Exercise Test Joint Instability Diagnosis Knee Joint Pathology Anterior Cruciate Ligament Injuries Complications Joint Instability Etiology Electromyography Videorecording Reproducibility of Results Human Canada Male Female Adolescence Adult Middle Age Comparative Studies Range of Motion Descriptive Statistics Data Analysis Software Multiple Logistic Regression Probability ROC Curve Spearman's Rank Correlation Coefficient Bivariate Statistics Sensitivity and Specificity Odds Ratio Confidence Intervals Task Performance and Analysis Validation Studies Validity Clinical Assessment Tools Biomechanics Muscle Contraction Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Background: The pivot shift is an important and widely used orthopaedic test for assessing anterior cruciate ligament (ACL)-deficient (ACL-D) knees. A continuous measure of the pivot shift test may allow for a more objective assessment of ACL laxity. Purpose: To assess the efficacy of a novel iPad application (PIVOT App) that uses video image analysis to evaluate ACL deficiency. The main objectives were to (1) assess the PIVOT App's ability to distinguish between categorically assigned pivot shift test grades; (2) assess the PIVOT App's ability to differentiate between normal and abnormal knees, and (3) quantify the effects of thigh muscle coactivity on pivot shift grades using electromyography (EMG) analysis. Study Design: Cohort Study (Diagnosis); Level of evidence, 3. Methods: ACL-deficient (ACL-D) participants recruited via convenience sampling underwent the pivot shift test on their injured and contralateral knees. Some patients were evaluated in the clinic (n = 33), and others were evaluated under anesthesia (n = 20). Control participants (n = 7) with no history of knee injury also had the pivot shift test conducted on both knees while awake in the clinic. Tests were graded categorically by the examiner and simultaneously videotaped and analyzed by the PIVOT App, while EMG activity was recorded from the rectus femoris and semitendinosus muscles. Results: Pivot shift grades 1, 2, and 3 classified knees showed a consistent, incremental increase in tibial reduction. Grade 0 knees showed lower tibial reduction than grade 2 and 3 knees (P <.05). The PIVOT App's classification accuracy of normal versus abnormal knees was 73%. There were no effects of RF or ST EMG activity on the pivot shift test. Conclusion: The PIVOT App is a promising, noninvasive measuring device that can provide an objective, continuous assessment of the pivot shift test, addressing multiple limitations of the current reference standard. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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