Centre de chirurgie orthopédique et de la main, hôpitaux universitaires de Strasbourg, Strasbourg, France.
Orthop Traumatol Surg Res. 2013 Oct;99(6 Suppl):S297-300. doi: 10.1016/j.otsr.2013.07.008. Epub 2013 Aug 9.
Anterior knee laxity measurement serves both to diagnose and to evaluate the severity of anterior cruciate ligament (ACL) damage.
We tested the hypothesis that anterior laxity measurements of ACL-deficient knees obtained using the GNRB(®) system and stress radiographs differed from each other and from intraoperative navigation measurement taken as the reference standard.
Twenty-one patients with chronic ACL deficiency underwent arthroscopic ACL reconstruction. Anterior knee laxity was measured preoperatively using the GNRB(®) system without anaesthesia and anterior-drawer stress radiographs under anaesthesia then intraoperatively using a non-image-based navigation system.
The three measurements differed significantly (P=0.05). A systematic measurement error of -3.7 mm occurred for both preoperative measurements versus the reference standard. No significant difference was found between the two preoperative measurements.
The GNRB(®) system should be preferred over stress radiographs, as reliability is similar but no radiation exposure is required. Both preoperative measurement methods underestimate anterior laxity as measured intraoperatively using the navigation system. This systematic bias may be relevant to treatment decision-making.
II, development of a diagnostic criterion in consecutive patients versus a validated reference standard.
膝关节前向松弛度的测量既可以用于诊断，也可以用于评估前交叉韧带（ACL）损伤的严重程度。
我们假设使用 GNRB（®）系统和应力位 X 线片测量的 ACL 缺失膝关节的前向松弛度与术中导航测量值（作为参考标准）不同。
21 例慢性 ACL 缺失患者接受了关节镜下 ACL 重建术。在无麻醉的情况下使用 GNRB（®）系统和麻醉下的前抽屉应力位 X 线片进行术前膝关节前向松弛度测量，然后使用非影像导航系统进行术中测量。
三种测量值差异显著（P=0.05）。与参考标准相比，两种术前测量值均存在-3.7mm 的系统测量误差。两种术前测量值之间无显著差异。
与应力位 X 线片相比，GNRB（®）系统更具优势，因为其可靠性相似，但无需辐射暴露。两种术前测量方法均低估了术中导航系统测量的膝关节前向松弛度。这种系统偏差可能与治疗决策有关。
II，在连续患者中开发诊断标准，与验证的参考标准进行比较。
