Arthroscopic Lateral Tibial Plateau Translation Correlates With Pivot-Shift Severity in Anterior Cruciate Ligament-Deficient Knees.
6 affiliations
- 1Department of Orthopaedics and Traumatology Hospital Universitario Austral Buenos Aires Argentina.
- 2Department of Orthopaedics University of São Paulo São Paulo Brazil.
- 3Hospital Vozandes Quito Ecuador.
- 4Universidad Internacional del Ecuador Quito Ecuador.
- 5Hospital Universitario Austral Buenos Aires Argentina.
- 6Department of Orthopaedics and Traumatology Clinica Arthros Quito Ecuador.
Abstract
Purpose
To quantify arthroscopic lateral tibial plateau (LTP) translation in anterior cruciate ligament (ACL)-deficient knees using a standardized intraoperative protocol and to evaluate its association with pivot-shift grade and lateral tibial slope, including its ability to discriminate high-grade pivot-shift.Methods
Patients aged 18 to 45 years with an isolated ACL rupture confirmed by clinical examination, magnetic resonance imaging, and arthroscopy who met the predefined eligibility criteria and had arthroscopic video of adequate quality for measurement underwent standardized arthroscopic assessment of LTP translation. Arthroscopic LTP translation was quantified from standardized high-definition arthroscopic video recordings using a calibrated probe during valgus and internal rotation stress at 30° of knee flexion. Measurements were independently repeated by 2 observers. Associations with preoperative pivot-shift grade and lateral tibial slope were assessed. Diagnostic performance was evaluated using receiver operating characteristic analysis.Results
Sixty patients (38 men, 22 women; mean age 29.8 ± 6.7 years) were included in the final analysis. Mean arthroscopic LTP translation was 4.6 ± 1.7 mm (range, 2-8 mm). Reproducibility was excellent (intraclass correlation coefficient intra = 0.91; inter = 0.89). LTP translation strongly correlated with pivot-shift grade (r = 0.72, P < .001) and moderately with lateral tibial slope (r = 0.51, P = .003). Receiver operating characteristic analysis showed an area under the curve of 0.85 (95% confidence interval, 0.77-0.93). A threshold of >5 mm yielded 82% sensitivity and 78% specificity for detecting high-grade pivot-shift.Conclusions
Arthroscopic quantification of LTP translation is a reproducible and clinically relevant method for objectively assessing rotational instability in ACL-deficient knees. Arthroscopic quantification of LTP translation showed excellent inter- and intraobserver reliability and was strongly associated with preoperative pivot-shift grade. A translation threshold greater than 5 mm showed good discriminative performance for identifying high-grade pivot-shift.Level of evidence
Level III, retrospective comparative study.
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BibTeX
@article{rivarola2026arthroscopic,
title = {{Arthroscopic Lateral Tibial Plateau Translation Correlates With Pivot-Shift Severity in Anterior Cruciate Ligament-Deficient Knees.}},
author = {Horacio Rivarola and Camilo Helito and Cristian Collazo and Marcos Palanconi and Marcos Meninato and Carlos Peñaherrera-Carrillo and Alejandro Barros Castro and Bautista Rivarola and Francisco Endara Urresta},
journal = {Arthroscopy, sports medicine, and rehabilitation},
year = {2026},
month = oct,
doi = {10.1002/ars2.70113},
url = {https://europepmc.org/article/MED/42923767},
note = {CC BY},
}
RIS
TY - JOUR
TI - Arthroscopic Lateral Tibial Plateau Translation Correlates With Pivot-Shift Severity in Anterior Cruciate Ligament-Deficient Knees.
AU - Horacio Rivarola
AU - Camilo Helito
AU - Cristian Collazo
AU - Marcos Palanconi
AU - Marcos Meninato
AU - Carlos Peñaherrera-Carrillo
AU - Alejandro Barros Castro
AU - Bautista Rivarola
AU - Francisco Endara Urresta
PY - 2026
DA - 2026/10/22
JO - Arthroscopy, sports medicine, and rehabilitation
DO - 10.1002/ars2.70113
UR - https://europepmc.org/article/MED/42923767
AB - Purpose To quantify arthroscopic lateral tibial plateau (LTP) translation in anterior cruciate ligament (ACL)-deficient knees using a standardized intraoperative protocol and to evaluate its association with pivot-shift grade and lateral tibial slope, including its ability to discriminate high-grade pivot-shift.Methods Patients aged 18 to 45 years with an isolated ACL rupture confirmed by clinical examination, magnetic resonance imaging, and arthroscopy who met the predefined eligibility criteria and had arthroscopic video of adequate quality for measurement underwent standardized arthroscopic assessment of LTP translation. Arthroscopic LTP translation was quantified from standardized high-definition arthroscopic video recordings using a calibrated probe during valgus and internal rotation stress at 30° of knee flexion. Measurements were independently repeated by 2 observers. Associations with preoperative pivot-shift grade and lateral tibial slope were assessed. Diagnostic performance was evaluated using receiver operating characteristic analysis.Results Sixty patients (38 men, 22 women; mean age 29.8 ± 6.7 years) were included in the final analysis. Mean arthroscopic LTP translation was 4.6 ± 1.7 mm (range, 2-8 mm). Reproducibility was excellent (intraclass correlation coefficient intra = 0.91; inter = 0.89). LTP translation strongly correlated with pivot-shift grade (r = 0.72, P < .001) and moderately with lateral tibial slope (r = 0.51, P = .003). Receiver operating characteristic analysis showed an area under the curve of 0.85 (95% confidence interval, 0.77-0.93). A threshold of >5 mm yielded 82% sensitivity and 78% specificity for detecting high-grade pivot-shift.Conclusions Arthroscopic quantification of LTP translation is a reproducible and clinically relevant method for objectively assessing rotational instability in ACL-deficient knees. Arthroscopic quantification of LTP translation showed excellent inter- and intraobserver reliability and was strongly associated with preoperative pivot-shift grade. A translation threshold greater than 5 mm showed good discriminative performance for identifying high-grade pivot-shift.Level of evidence Level III, retrospective comparative study.
SN - 2666-061X
ER -