Kovaleski John E, Hollis J, Heitman Robert J, Gurchiek Larry R, Pearsall Albert W
University of South Alabama, Mobile, AL.
J Athl Train. 2002 Dec;37(4):467-474.
To show the relationship between direct measurements of tibial-calcaneal bone motion and instrumented measurements of ankle-subtalar-joint-complex laxity using a portable ankle arthrometer; to assess within and between-tester measurement reliability; and to determine if the ankle arthrometer can detect increased mechanical laxity of the ankle-subtalar-joint-complex after simulated injury of the lateral ankle ligaments. DESIGN AND SETTING: We used linear regression analysis to examine the relationship between direct measurements of tibial-calcaneal bone motion and instrumented measurements of ankle-subtalar-joint-complex laxity. An intraclass correlation coefficient (2,1) was calculated to determine intratester and intertester reliability for instrumented measurements of ankle-subtalar-joint-complex laxity. In addition, 2 separate, one-way, repeated-measures analyses of variance were used to compare instrumented measures of anteroposterior displacement and inversion-eversion rotation among the intact ankles after sectioning the anterior talofibular ligament and both the anterior talofibular and calcaneofibular ligaments. Data were collected in a biomechanics laboratory setting. SUBJECTS: Six fresh-frozen human-cadaver ankle specimens were studied. MEASUREMENTS: Testing involved the concurrent measurement of tibial-calcaneal bone motion and ankle-subtalar-joint-complex motion during the application of external loads. An instrumented ankle arthrometer was used to load the ankle in a controlled manner. Two spatial kinematic linkages measured the 3-dimensional motion of the calcaneus relative to the tibia and the motion of the arthrometer's footplate relative to the tibia. RESULTS: The correlation between tibial-calcaneal bone motion and instrumented measurement for anterior-posterior displacement was.878 (P =.0001). Its linear relationship with bone motion accounted for approximately 77% of the variance of the instrumented measurement. The correlation between tibial-calcaneal bone motion and instrumented measurement for inversion-eversion rotation was.858 (P =.0001), with approximately 74% of the variance of the instrumented measurement accounted for by its linear relationship with bone motion. High intratester and intertester reliability coefficients (ICC [2,1] =.80 to.97) were observed for instrumented measurements of ankle-subtalar-joint-complex laxity. In addition, ligamentous sectioning resulted in significantly increased ankle-subtalar-joint-complex laxity. When compared with the intact condition, sectioning both the anterior talofibular and calcaneofibular ligaments produced significant increases in anterior-posterior displacement (P =.0001) and inversion-eversion rotation (P =.002). CONCLUSIONS: We found a strong relationship between tibial-calcaneal bone motion and arthrometric measurements of ankle-subtalar-joint-complex laxity. The instrumented ankle arthrometer may be suitable as a diagnostic tool for the evaluation of lateral ankle-ligament laxity.
利用便携式踝关节测角仪展示胫跟骨运动的直接测量值与踝-距下关节复合体松弛度的仪器测量值之间的关系;评估测试者内部和测试者之间测量的可靠性;并确定踝关节测角仪能否在模拟外侧踝关节韧带损伤后检测出踝-距下关节复合体机械松弛度的增加。
我们使用线性回归分析来研究胫跟骨运动的直接测量值与踝-距下关节复合体松弛度的仪器测量值之间的关系。计算组内相关系数(2,1)以确定踝-距下关节复合体松弛度仪器测量的测试者内部和测试者之间的可靠性。此外,使用2个独立的单因素重复测量方差分析来比较切断距腓前韧带以及距腓前韧带和跟腓韧带后完整踝关节前后位移和内翻-外翻旋转的仪器测量值。数据在生物力学实验室环境中收集。
研究了6个新鲜冷冻的人体尸体踝关节标本。
测试包括在施加外部负荷期间同时测量胫跟骨运动和踝-距下关节复合体运动。使用仪器化的踝关节测角仪以可控方式加载踝关节。两个空间运动学连杆测量跟骨相对于胫骨的三维运动以及测角仪踏板相对于胫骨的运动。
胫跟骨运动与前后位移仪器测量值之间的相关性为0.878(P = 0.0001)。其与骨运动的线性关系约占仪器测量方差的77%。胫跟骨运动与内翻-外翻旋转仪器测量值之间的相关性为0.858(P = 0.0001),其与骨运动的线性关系约占仪器测量方差的74%。观察到踝-距下关节复合体松弛度仪器测量的测试者内部和测试者之间的可靠性系数较高(ICC [2,1] = 0.80至0.97)。此外,韧带切断导致踝-距下关节复合体松弛度显著增加。与完整状态相比,切断距腓前韧带和跟腓韧带后前后位移(P = 0.0001)和内翻-外翻旋转(P = 0.002)显著增加。
我们发现胫跟骨运动与踝-距下关节复合体松弛度的测角测量之间存在密切关系。仪器化的踝关节测角仪可能适合作为评估外侧踝关节韧带松弛度的诊断工具。