Schulz Martin S, Russe Kai, Lampakis Georgios, Strobel Michael J
Orthopaedische Gemeinschaftspraxis Straubing, Hebbelstrasse 14a, 94315 Straubing, Germany.
Am J Sports Med. 2005 Apr;33(4):502-6. doi: 10.1177/0363546504269723. Epub 2005 Feb 8.
Although stress radiography has been recommended for quantifying posterior tibial displacement in knees with posterior cruciate ligament insufficiency, the intratester reliability and intertester reliability of this measurement method have not been evaluated.
Stress radiography is a reproducible measurement method in the assessment of posterior knee laxity in patients with posterior cruciate ligament lesions.
Cohort study (diagnosis); Level of evidence, 2.
Stress radiographs of 787 patients with suspected posterior cruciate ligament lesions taken using the Telos device were evaluated independently by 3 testers: 2 of the testers were clinically experienced in the evaluation of stress radiographs, and 1 tester was a novice tester. Change in mean, standard error of measurement with calculated confidence intervals, and intra-class correlation coefficients were determined to assess intratester and intertester reliability.
There was no significant intratester change in mean. Intratester standard error of measurement was 1.03 mm; 95% confidence intervals were+/-2.02 mm for a single measurement and+/-2.86 mm for a change in measurement. The intratester intra-class correlation coefficient was 0.95. Intertester reliability revealed a significant change in mean between the experienced testers and the novice tester (P<.001). There was no substantial difference for the standard error of measurement of each tester. The mean intertester standard error of measurement was 1.41 mm; 95% confidence intervals were+/-2.77 mm for a single measurement and+/-3.91 mm for a change in measurement. The intertester intraclass correlation coefficient was 0.91.
Stress radiography was found to be a measurement method with a useful reliability for evaluation of posterior laxity in patients with posterior cruciate ligament lesions. The reproducibility of stress radiography may be influenced by multiple variables, and standardized methods are needed to minimize measurement error.
尽管应力位X线摄影已被推荐用于量化后交叉韧带功能不全膝关节的胫骨后移，但该测量方法的测试者内可靠性和测试者间可靠性尚未得到评估。
应力位X线摄影是评估后交叉韧带损伤患者膝关节后向松弛度的一种可重复测量方法。
队列研究（诊断）；证据等级，2级。
使用Telos设备对787例疑似后交叉韧带损伤患者进行应力位X线摄影，由3名测试者独立评估：其中2名测试者在应力位X线摄影评估方面有临床经验，1名测试者为新手测试者。通过确定均值变化、测量标准误差及计算置信区间和组内相关系数来评估测试者内和测试者间的可靠性。
均值在测试者内无显著变化。测试者内测量标准误差为1.03mm；单次测量的95%置信区间为±2.02mm，测量变化的95%置信区间为±2.86mm。测试者内组内相关系数为0.95。测试者间可靠性显示，经验丰富的测试者与新手测试者之间均值有显著变化（P<0.001）。各测试者测量标准误差无实质性差异。测试者间平均测量标准误差为1.41mm；单次测量 的95%置信区间为±2.77mm，测量变化的95%置信区间为±3.91mm。测试者间组内相关系数为0.91。
应力位X线摄影被发现是一种评估后交叉韧带损伤患者后向松弛度可靠性良好的测量方法。应力位X线摄影的可重复性可能受多种变量影响，需要标准化方法以尽量减少测量误差。
