Muller Bart, Hofbauer Marcus, Rahnemai-Azar Amir Ata, Wolf Megan, Araki Daisuke, Hoshino Yuichi, Araujo Paulo, Debski Richard E, Irrgang James J, Fu Freddie H, Musahl Volker
a Orthopaedic Robotics Laboratory, Department of Orthopaedic Surgery and Department of Bioengineering , University of Pittsburgh , Pittsburgh PA , USA.
Comput Methods Biomech Biomed Engin. 2016;19(2):217-28. doi: 10.1080/10255842.2015.1006210. Epub 2015 Feb 9.
The pivot shift test is a commonly used clinical examination by orthopedic surgeons to evaluate knee function following injury. However, the test can only be graded subjectively by the examiner. Therefore, the purpose of this study is to develop software for a computer tablet to quantify anterior translation of the lateral knee compartment during the pivot shift test. Based on the simple image analysis method, software for a computer tablet was developed with the following primary design constraint - the software should be easy to use in a clinical setting and it should not slow down an outpatient visit. Translation of the lateral compartment of the intact knee was 2.0 ± 0.2 mm and for the anterior cruciate ligament-deficient knee was 8.9 ± 0.9 mm (p < 0.001). Intra-tester (ICC range = 0.913 to 0.999) and inter-tester (ICC = 0.949) reliability were excellent for the repeatability assessments. Overall, the average percent error of measuring simulated translation of the lateral knee compartment with the tablet parallel to the monitor increased from 2.8% at 50 cm distance to 7.7% at 200 cm. Deviation from the parallel position of the tablet did not have a significant effect until a tablet angle of 45°. Average percent error during anterior translation of the lateral knee compartment of 6mm was 2.2% compared to 6.2% for 2 mm of translation. The software provides reliable, objective, and quantitative data on translation of the lateral knee compartment during the pivot shift test and meets the design constraints posed by the clinical setting.
轴移试验是骨科医生常用的一种临床检查方法，用于评估膝关节损伤后的功能。然而，该试验只能由检查者进行主观评分。因此，本研究的目的是开发一款用于电脑平板的软件，以量化轴移试验过程中外侧膝关节间室的前向移位。基于简单的图像分析方法，开发了一款用于电脑平板的软件，其主要设计约束如下——该软件应易于在临床环境中使用，且不应延长门诊就诊时间。完整膝关节外侧间室的移位为2.0±0.2毫米，前交叉韧带损伤膝关节的移位为8.9±0.9毫米（p<0.001）。测试者内（组内相关系数范围=0.913至0.999）和测试者间（组内相关系数=0.949）的可靠性在重复性评估中表现出色。总体而言，平板与显示器平行时测量外侧膝关节间室模拟移位的平均百分比误差从50厘米距离处的2.8%增加到200厘米距离处的7.7%。直到平板角度达到45°，平板偏离平行位置才产生显著影响。外侧膝关节间室前向移位6毫米时的平均百分比误差为2.2%，而移位2毫米时为6.2%。该软件提供了关于轴移试验过程中外侧膝关节间室移位的可靠、客观和定量数据，并满足了临床环境提出的设计约束。
