Abstract
Anterior tibia translation (ATT) is mainly prevented by the anterior cruciate ligament. Passive ATT tests are commonly used to diagnose an anterior cruciate ligament (ACL) injury, to select patients for an ACL reconstruction (ACLR), and as an outcome measure after an ACLR. The aim of this review was to present an overview of possible factors determining ATT. A second purpose was to give a summary of the ATT measured in the literature in healthy, ACL-injured and ACLR knees and a comparison between those groups. A literature search was conducted with PubMed. Inclusion criteria were full-text primary studies published in English between January 2006 and October 2016. Studies included reported ATT in explicit data in healthy as well as ACL-injured or ACLR knees or in ACL-injured as well as ACLR knees. Sixty-one articles met inclusion criteria. Two articles measured the ATT in healthy as well as ACL-injured knees, 51 in ACL-injured as well as in ACLR knees, three in ACLR as well as in healthy knees and three in healthy, ACL-injured and ACLR knees. A difference in ATT is found between healthy, contralateral, ACLR and ACL-injured knees and between chronic and acute ACL injury. Graft choices and intra-articular injuries are factors which could affect the ATT. The mean ATT was lowest to highest in ACLR knees using a bone–patella tendon–bone autograft, ACLR knees using a hamstring autograft, contralateral healthy knees, healthy knees, ACLR knees with an allograft and ACL-injured knees. Factors which could affect the ATT are graft choice, ACL injury or reconstruction, intra-articular injuries and whether an ACL injury is chronic or acute. Comparison of ATT between studies should be taken with caution as a high number of different measurement methods are used. To be able to compare studies, more consistency in measuring devices used should be introduced to measuring ATT. The clinical relevance is that an autograft ACLR might give better results than an allograft ACLR as knee laxity is greater when using an allograft tendon.Level of evidenceIII.
Highlights
Anterior tibia translation (ATT) is mainly prevented by the anterior cruciate ligament (ACL) [1]
One out of five studies which compared bone–patella tendon–bone (BPTB) autograft and hamstring autograft use reported a significant difference in favour of hamstring autografts [23]
A significantly higher ATT was found in patients who underwent ACL reconstruction (ACLR) using a 4-strand compared to an 8-strand hamstring autograft [24], in patients who underwent ACLR using a Leeds-Keio ligament compared to using a BPTB autograft at 2 years after reconstruction [25] and in patients who underwent ACLR using a calcium phosphate-hybridised BPTB autograft in comparison with the conventional method [26]
Summary
Anterior tibia translation (ATT) is mainly prevented by the anterior cruciate ligament (ACL) [1]. An ACL injury results in higher ATT with respect to the femur. To reduce the increased ATT after an ACL injury, an ACL reconstruction (ACLR) is warranted [2]. Several methods can be used to assess the ATT. These tests could either be clinical tests, i.e. the Lachman test, or instrumental measuring methods The most frequently used instrumental measuring method is the KT-1000 arthrometer (KT-1000) (Medmetric Corp., San Diego, CA, USA) developed by Dale Daniel in 1983 [8]. Using the KT-1000 and its successors, the KT-2000 [9] and the ComputKT, an examiner applies forces to the tibia using a handle on top of the device.
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