Saúde Atlântica Sports Center—F.C. Porto Stadium, Minho University and Porto University, Porto, Portugal.
Knee Surg Sports Traumatol Arthrosc. 2012 Apr;20(4):671-8. doi: 10.1007/s00167-012-1914-9.
Objective evaluation of both antero-posterior translation and rotatory laxity of the knee remains a target to be accomplished. This is true for both preoperative planning and postoperative assessment of different ACL reconstruction emerging techniques. The ideal measurement tool should be simple, accurate and reproducible, while enabling to assess both ‘‘anatomy’’ and ‘‘function’’ during the same examination. The purpose of this study is to evaluate the clinical effectiveness of a new in-house developed testing device, the so-called Porto-knee testing device (PKTD). The PKTD is aimed to be used on the evaluation of both antero-posterior and rotatory laxity of the knee during MRI exams.
Between 2008 and 2010, 33 patients with ACLdeficient knees were enrolled for the purpose of this study. All patients were evaluated in the office and under anesthesia with Lachman test, lateral pivot-shift test and anterior drawer test. All cases were studied preoperatively with KT-1000 and MRI with PKTD, and examinations performed by independent observers blinded for clinical evaluation. During MRI, we have used a PKTD that applies antero-posterior translation and permits free tibial rotation through a standardized pressure (46.7 kPa) in the proximal posterior region of the leg. Measurements were taken for both knees and comparing side-to-side. Five patients with partial ruptures were excluded from the group of 33.
For the 28 remaining patients, 3 women and 25 men, with mean age of 33.4 ± 9.4 years, 13 left and 15 right knees were tested. No significant correlation was noticed for Lachman test and PKTD results (n.s.). Pivot-shift had a strong positive correlation with the difference in anterior translation registered in lateral and medial tibia plateaus of injured knees (cor. coefficient = 0.80; p\0.05), and with the difference in this parameter as compared to side-to-side (cor. coefficient = 0.83; p\0.05). Considering the KT-1000 difference between injured and healthy knees, a very strong positive correlation was found for side-to-side difference in medial (cor. coefficient = 0.73; p\0.05) and lateral (cor. coefficient = 0.5; p\0.05) tibial plateau displacement using PKTD.
The PKTD proved to be a reliable tool in assessment of antero-posterior translation (comparing with KT-1000) and rotatory laxity (compared with lateral pivotshift under anesthesia) of the ACL-deficient knee during MRI examination.
Therapeutic studies, Level IV.
客观评估膝关节前后向平移和旋转松弛度仍然是一个有待实现的目标。这对于术前规划和不同 ACL 重建新技术的术后评估都是如此。理想的测量工具应该简单、准确且可重复，同时能够在同一检查中评估“解剖结构”和“功能”。本研究的目的是评估一种新的内部开发的测试设备，即所谓的 Porto-knee 测试设备（PKTD）的临床效果。PKTD 的目的是在 MRI 检查中评估 ACL 缺失膝关节的前后向平移和旋转松弛度。
2008 年至 2010 年间，纳入 33 例 ACL 缺失膝关节患者进行本研究。所有患者均在办公室和麻醉下接受 Lachman 试验、外侧枢轴移位试验和前抽屉试验评估。所有病例均在术前接受 KT-1000 和 MRI 检查，并由独立观察者进行检查，这些观察者对临床评估不了解。在 MRI 检查中，我们使用了一种 PKTD，该设备施加前后向平移，并通过腿部近端后区域的标准化压力（46.7 kPa）允许胫骨自由旋转。对双侧膝关节进行测量并进行比较。28 例患者中有 5 例存在部分撕裂，被排除在 33 例患者之外。
对于 28 名仍有膝关节的患者（3 名女性和 25 名男性，平均年龄 33.4 ± 9.4 岁，13 例左膝和 15 例右膝），未发现 Lachman 试验和 PKTD 结果之间存在显著相关性（n.s.）。枢轴移位与受伤膝关节内外侧胫骨平台上记录的前向平移差异具有很强的正相关性（相关系数=0.80；p\0.05），并且与双侧差异具有很强的正相关性（相关系数=0.83；p\0.05）。考虑到 KT-1000 测量的受伤和健康膝关节之间的差异，使用 PKTD 测量内侧（相关系数=0.73；p\0.05）和外侧（相关系数=0.5；p\0.05）胫骨平台位移的双侧差异具有很强的正相关性。
PKTD 被证明是一种可靠的工具，可在 MRI 检查中评估 ACL 缺失膝关节的前后向平移（与 KT-1000 相比）和旋转松弛度（与麻醉下的外侧枢轴移位相比）。
治疗研究，IV 级。
