Abstract
PurposeThe aim of this study was to quantify sagittal and rotational knee laxity profiles taking into account individual influencing factors.MethodsLinear regression models were used to determine which individual characteristics (age, height, body mass and sex) influenced the outcome in a group of 104 healthy subjects. The standardized residuals were used as individualized (corrected) laxity scores and were combined to determine knee laxity profiles. ResultsAnterior knee laxity was not influenced by individual characteristics. Rotational knee laxity was higher in females and inversely related to body mass. The correlation between anterior laxity and internal rotation scores was weak (r = 0.24, p = 0.02). The proportion of knees concerned by increased laxity scores (scores >1) was similar for anterior displacement, internal and external rotation (15 %). Only 32 % of the tested subjects showed a normal profile (score >−1 and <1) for all three directions, 33 % were concerned by hyperlaxity, 40 % by hypolaxity and 5 % by both. ConclusionsThe diversity of laxity profiles found here highlights that the interpretation of multidirectional knee laxity is complex and suggests the necessity for individualized care of knee diseases and injuries. These results contribute to the understanding of knee laxity and throw the basis for prevention strategies and improvement of treatment outcomes in injuries and diseases.Level of evidenceCase series with no comparison groups, Level IV.
Highlights
Defining physiological knee laxity, i.e. the natural knee laxity of non-symptomatic and non-traumatic individuals, is a complex issue because of the wide variety of individual anatomical properties of each knee joint
Meyer Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany individualized care of knee diseases and injuries. These results contribute to the understanding of knee laxity and throw the basis for prevention strategies and improvement of treatment outcomes in injuries and diseases
The average, standard deviation and minimum detectable change (MDC) for absolute and SSD measurements are presented in Table 1 for both anterior and static rotational knee laxity
Summary
I.e. the natural knee laxity of non-symptomatic and non-traumatic individuals, is a complex issue because of the wide variety of individual anatomical properties of each knee joint. Laxity has been considered to play a role in the development of knee osteoarthritis (OA) [25] and the occurrence of primary non-contact anterior cruciate ligament (ACL) injuries [22], secondary knee injuries [15] as well as worse ACL reconstruction outcomes [4, 8]. No data are available on physiological knee laxity. Establishing individual knee laxity profiles may be helpful to improve the prognostic and therapeutic criteria for primary and recurrent knee injuries and diseases. Sagittal knee laxity measurements are widely used in the context of ACL injuries diagnosis [23] and reconstructions [11]. The interest to measure rotational laxities is relatively new and arose as a consequence of the discussion on the lack of rotational control provided by the technique of ACL reconstructions which were performed a decade ago [4, 10].
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