Department of Orthopedic Surgery, Saarland University, Kirrberger Str., 66421 Homburg (Saar), Germany.
Knee Surg Sports Traumatol Arthrosc. 2012 Apr;20(4):639-44. doi: 10.1007/s00167-011-1876-3. Epub 2012 Jan 14.
The present article summarizes the development of a simple, objective, and non-invasive measurement device for tibiofemoral rotation to assess static rotational knee laxity.
The device is based on the dial test with the patient lying prone and the knee flexed to 30°. From measurements of 30 healthy participants, the device achieved high inter- and intra-observer reliability and showed a high correlation of the measured results with the contralateral knees of the participants. Measurements of the device were also performed in a human cadaver study and revealed highly correlated results when compared to the simultaneous measurements of a knee navigation system, which was used as an invasive standard method to assess tibial rotation. In human cadaver specimens, it was shown that a simulated tear of the posterolateral bundle as well as a complete ACL tear led to a significant increase in isolated tibiofemoral rotation compared to the intact ACL. A retrospective case series investigated the clinical results as well as knee laxity measurements after ACL surgery in vivo. Rotational, as well as anteroposterior (AP), knee laxity was objectively assessed in 52 patients at a mean postoperative follow-up of 27 months by comparing the measured results with the results of the contralateral unaffected knee in each patient. The clinical results were comparable to the results reported in the literature. Moreover, rotational laxity was successfully restored after ACL reconstruction, whereas AP laxity showed significant differences compared to the contralateral knees although they were defined as clinically successful according to the IKDC classification.
A non-invasive and objective knee rotational measurement device has been developed, which offers good potential for objective quality control in knee ligament injuries and their treatment.
Review article, Level IV.
本文总结了一种简单、客观、非侵入性的测量装置，用于评估静态旋转膝关节松弛度的胫骨股骨旋转。
该设备基于患者仰卧位、膝关节弯曲 30°时的Dial 测试。从 30 名健康参与者的测量中，该设备实现了高的观察者内和观察者间可靠性，并显示出与参与者对侧膝关节高度相关的测量结果。该设备的测量也在人体尸体研究中进行，与用作评估胫骨旋转的侵入性标准方法的膝关节导航系统的同时测量结果高度相关。在人体尸体标本中，模拟后外侧束撕裂以及完全前交叉韧带撕裂与完整前交叉韧带相比，导致孤立的胫骨股骨旋转显著增加。回顾性病例系列研究了 ACL 手术后体内的临床结果和膝关节松弛度测量。通过将测量结果与每位患者的对侧未受影响的膝关节的结果进行比较，在 52 名患者中平均术后随访 27 个月时，客观评估了旋转和前后（AP）膝关节松弛度。临床结果与文献报道的结果相当。此外，ACL 重建后成功恢复了旋转松弛度，而 AP 松弛度与对侧膝关节相比存在显著差异，尽管根据 IKDC 分类它们被定义为临床成功。
已经开发出一种非侵入性和客观的膝关节旋转测量装置，它为膝关节韧带损伤及其治疗的客观质量控制提供了良好的潜力。
综述文章，IV 级。
