{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:14:46Z","timestamp":1786979686148,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,6,15]],"date-time":"2016-06-15T00:00:00Z","timestamp":1465948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,6,15]],"date-time":"2016-06-15T00:00:00Z","timestamp":1465948800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this study was to validate the quantitation of the pivot\u2010shift phenomenon by using a navigation system with non\u2010invasive surface markers. Measurements obtained using this system were compared with those obtained using commercial pin\u2010fixed markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventy patients with anterior cruciate ligament (ACL) injuries were assessed under general anaesthesia. Knee kinematics during the pivot\u2010shift test were recorded using an image\u2010free navigation system with a commercial transmitter placed on the thigh and lower leg (surface markers) or those fixed to the femur and the tibia via metal pin fixators (pin\u2010fixed markers). For quantitation of the pivot\u2010shift phenomenon, posterior tibial reduction (PTR) was calculated using the two types of navigation system markers and were then compared. PTRs measured using the two types of markers were also compared with clinical grade of the pivot\u2010shift test, as determined by an examiner.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The pivot\u2010shift phenomenon could be identified in all patients on the navigation screen. The PTR measured using surface markers moderately correlated with that measured using pin\u2010fixed markers (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      = 0.524,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). There were also moderate correlations between clinical grades and the PTRs measured using either the surface markers (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      = 0.522,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) or the pin\u2010fixed markers (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      = 0.645,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The present study demonstrated that PTR, during the pivot\u2010shift test, may be quantified in ACL\u2010injured knees, using a navigation system with surface markers, and that the PTR measured with surface markers moderately correlated both with the PTR obtained using pin\u2010fixed markers and with the clinical grade of the pivot\u2010shift test. A customised method of fixing transmitters with reflective markers to patients\u2019 thighs and shins with Velcro straps is non\u2010invasive and could assess and record the knee kinematics, especially the pivot\u2010shift test, in ACL\u2010injured and ACL\u2010reconstructed knees before, during, and after surgery using a navigation system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Case series, Level IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00167-016-4165-3","type":"journal-article","created":{"date-parts":[[2016,6,15]],"date-time":"2016-06-15T12:13:02Z","timestamp":1465992782000},"page":"3612-3618","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Quantification of the pivot\u2010shift test using a navigation system with non\u2010invasive surface markers"],"prefix":"10.1002","volume":"24","author":[{"given":"Shugo","family":"Maeda","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Hirosaki University Graduate School of Medicine 5 Zaifu\u2010cho 036\u20108562 Hirosaki, Aomori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiichi","family":"Tsuda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hirosaki University Graduate School of Medicine 5 Zaifu\u2010cho 036\u20108562 Hirosaki, Aomori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hirosaki University Graduate School of Medicine 5 Zaifu\u2010cho 036\u20108562 Hirosaki, Aomori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Naraoka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hirosaki University Graduate School of Medicine 5 Zaifu\u2010cho 036\u20108562 Hirosaki, Aomori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hirosaki University Graduate School of Medicine 5 Zaifu\u2010cho 036\u20108562 Hirosaki, Aomori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Ishibashi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hirosaki University Graduate School of Medicine 5 Zaifu\u2010cho 036\u20108562 Hirosaki, Aomori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.2834888"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101862\u20109"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010199906000\u201000029"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198003000-00008"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01560215"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101845\u2010x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507299447"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2008.10.008"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016470410001484"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2008.08.010"},{"key":"e_1_2_8_12_1","first-page":"s1283","article-title":"Computer\u2010assisted 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