Jackman Todd, LaPrade Robert F, Pontinen Thomas, Lender Paul A
Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue, R200, Minneapolis, MN 55454, USA.
Am J Sports Med. 2008 Aug;36(8):1571-6. doi: 10.1177/0363546508315897. Epub 2008 Apr 30.
Stress radiography provides an objective tool to measure posterior knee instability. Intraobserver and interobserver reliability has been reported for the Telos device, but it has not been studied using the kneeling technique.
This study was conducted to evaluate the intraobserver and interobserver reliability of measurements made using kneeling stress radiography to quantify posterior knee instability.
Case series (diagnosis); Level of evidence, 4.
One hundred thirty-two stress radiographs in 44 patients with suspected posterior knee instability were prospectively taken using the kneeling technique. The amount of posterior displacement on the radiographs was then measured independently by 3 blinded testers (an orthopaedic sports medicine faculty member, an orthopaedic chief resident, and a medical student) on 2 separate occasions. Changes in mean and intraclass correlation coefficients (ICCs) were examined to assess the intraobserver and interobserver reliability of the measurements.
Intraobserver changes in displacement means were small (-0.307 mm, -0.294 mm, and +0.035 mm) and only significant for observer 1. The combined intraobserver ICC was 0.973 for the 3 observers (0.976, 0.959, and 0.981). Interobserver comparisons revealed significant differences in trial 1 between observers 2 and 3 (0.675 mm), no differences in trial 2, and significant differences between observers 1 and 2 (0.333 mm) and observers 2 and 3 (0.510 mm) in the combined trial data. The combined interobserver ICC was 0.955 for the 3 observers (0.959 and 0.951 for the 2 trials).
The kneeling technique for posterior cruciate ligament stress radiography provides a reproducible method to quantify posterior knee instability.
应力放射成像提供了一种客观工具来测量膝关节后向不稳定。已有关于Telos设备的观察者内和观察者间可靠性的报道，但尚未使用跪姿技术进行研究。
本研究旨在评估使用跪姿应力放射成像来量化膝关节后向不稳定时测量的观察者内和观察者间可靠性。
病例系列（诊断）；证据等级，4级。
对44例疑似膝关节后向不稳定的患者前瞻性地采用跪姿技术拍摄了132张应力放射片。然后由3名不知情的测试者（一名骨科运动医学教员、一名骨科住院总医师和一名医学生）在2个不同时间独立测量放射片上的后向移位量。检查均值变化和组内相关系数（ICC）以评估测量的观察者内和观察者间可靠性。
观察者内移位均值变化较小（分别为-0.307mm、-0.294mm和+0.035mm），仅观察者1的变化具有显著性。3名观察者的联合观察者内ICC为0.973（分别为0.976、0.959和0.981）。观察者间比较显示，在试验1中观察者2和3之间存在显著差异（0.675mm），试验2中无差异，在联合试验数据中观察者1和2之间（0.333mm）以及观察者2和3之间（0.510mm）存在显著差异。3名观察者的联合观察者间ICC为0.955（2次试验分别为0.959和0.951）。
后交叉韧带应力放射成像的跪姿技术提供了一种可重复的方法来量化膝关节后向不稳定。
