Abstract
PurposeThe aim of this study was to determine the inter- and intra-observer reliability of knee laxity assessment using a non-invasive navigation system in a population of healthy young athletes. It was hypothesized that knee laxity parameters recorded using non-invasive computer navigation would demonstrate good inter- and intra-observer reliability.MethodsHealthy volunteers aged between 18 to 30 years were recruited to the study. Static and dynamic knee laxity parameters including anterior tibial translation and tibial rotation during the pivot shift test were recorded on awake patients using non-invasive computer navigation by two independent observers: at the first visit each athlete was evaluated by the consultant and resident surgeons independently; 6 weeks after the first visit all the participants were re-tested only by the resident surgeon. Inter- and intra-observer reliability was calculated and then interpreted according to Cicchetti’s criteria.ResultsOne hundred healthy volunteers were recruited to the study, of these 38 were women (38%), and the average age was 25.5 ± 2.4 years. According to Cicchetti’s criteria the intra- and inter-observer reliability for static measurements were fair for anterior tibial translation (0.572 and 0.529, respectively) and excellent for total passive tibial rotation (0.859 and 0.883, respectively). For the dynamic measurements of translation and rotation during the pivot shift maneuver both measurements demonstrated good to excellent reliability with intra and inter observer reliability ranging from 0.684 to 0.936.ConclusionNon-invasive navigation for the assessment of knee laxity is associated with fair to excellent inter- and intra-observer reliability in a population of healthy volunteers.
Highlights
The Lachman and Pivot Shift (PS) tests are respectively recognized as the most sensitive and specific physical examination tests for the diagnosis of anterior cruciate ligament (ACL) rupture [1, 15]
Considerable effort has been made to try and reduce some of the subjective aspects of these tests. This has included a preference to perform them under anesthesia, using standardized examination techniques, and utilizing technology to try and avoid the requirement for the observer to estimate tibial translation and rotation. This technology has included the use of electromagnetic sensors [5, 12, 13, 22], accelerometers [10, 18, 20], image analysis [11, 23] and navigation systems [14, 17], all of which have been developed and evaluated for their role in reducing subjectivity and improving inter- and intra-observer reliability in the assessment of knee laxity parameters
It was hypothesized that knee laxity parameters recorded using non-invasive computer navigation would demonstrate good inter- and intra-observer reliability
Summary
The Lachman and Pivot Shift (PS) tests are respectively recognized as the most sensitive and specific physical examination tests for the diagnosis of anterior cruciate ligament (ACL) rupture [1, 15]. This has included a preference to perform them under anesthesia (to minimize the effect of guarding and apprehension), using standardized examination techniques, and utilizing technology to try and avoid the requirement for the observer to estimate tibial translation and rotation This technology has included the use of electromagnetic sensors [5, 12, 13, 22], accelerometers [10, 18, 20], image analysis [11, 23] and navigation systems [14, 17], all of which have been developed and evaluated for their role in reducing subjectivity and improving inter- and intra-observer reliability in the assessment of knee laxity parameters. The use of non-invasive navigation systems has been considered as an alternative
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