Bach B R, Warren R F, Flynn W M, Kroll M, Wickiewiecz T L
Department of Sports Medicine, Hospital for Special Surgery, New York City, N.Y. 10007.
J Bone Joint Surg Am. 1990 Oct;72(9):1299-306.
We used the KT-1000 arthrometer to test the knees of 107 patients who had an acute tear of the anterior cruciate ligament, 153 patients who had a chronic tear, and 141 control subjects, for a total of 401 individuals. The three testing parameters were the extent of anterior translation at eighty-nine newtons of force and at maximum manual force, and the compliance index. The differences between the involved and the uninvolved knees were calculated. At eighty-nine newtons, all but one of the control subjects had anterior translation of ten millimeters or less, compared with 58 per cent of the patients who had a chronic tear. At maximum manual force, all but two of the control subjects had translation of ten millimeters or less, compared with 20 per cent of the patients who had an acute or a chronic tear. Analysis of variance showed that the clinical diagnosis correlated well with the results for all tests (p less than 0.001). However, when the uninjured knees of patients who had an acute or a chronic tear were compared with the knees of the control subjects, significant differences were noted (p less than 0.001 to 0.006). In the patients who had a chronic tear, there was no relationship between the time from injury to operation and the extent of anterior translation. The arthrometric test at maximum manual force was the strongest discriminant; it differentiated normal from abnormal knees (p less than 0.001) with high sensitivity (92 per cent), high specificity (95 per cent), and high positive predictive accuracy; the cut-off point was eleven millimeters or less.(ABSTRACT TRUNCATED AT 250 WORDS)
我们使用KT-1000关节测量仪对107例急性前交叉韧带撕裂患者、153例慢性撕裂患者以及141例对照者的膝关节进行检测,共计401人。三个检测参数为在89牛顿力和最大手动力时的前向移位程度以及顺应性指数。计算患侧与未患侧膝关节之间的差异。在89牛顿力时,除1例对照者外,所有对照者的前向移位均在10毫米或以下,而慢性撕裂患者中有58%超过此值。在最大手动力时,除2例对照者外,所有对照者的移位均在10毫米或以下,而急性或慢性撕裂患者中有20%超过此值。方差分析显示临床诊断与所有检测结果相关性良好(p<0.001)。然而,当将急性或慢性撕裂患者的未受伤膝关节与对照者的膝关节进行比较时,发现存在显著差异(p<0.001至0.006)。在慢性撕裂患者中,从受伤到手术的时间与前向移位程度之间无相关性。最大手动力时的关节测量测试是最强的判别方法;它能区分正常与异常膝关节(p<0.001),具有高敏感性(92%)、高特异性(95%)和高阳性预测准确性;截断点为11毫米或以下。(摘要截短至250字)