Stinton S K, Siebold R, Freedberg H, Jacobs C, Branch T P
University Orthopedics, 441 Armour PL NE, Decatur, GA, 30324, USA.
Institute for Anatomy and Cell Biology, Ruprecht-Karls-University, Heidelberg, Germany.
Knee Surg Sports Traumatol Arthrosc. 2016 Mar;24(3):815-22. doi: 10.1007/s00167-016-4042-0. Epub 2016 Feb 18.
The purpose of this study was to: (1) determine whether a robotic tibial rotation device and an electromagnetic tracking system could accurately reproduce the clinical dial test at 30° of knee flexion; (2) compare rotation data captured at the footplates of the robotic device to tibial rotation data measured using an electromagnetic sensor on the proximal tibia.
Thirty-two unilateral ACL-reconstructed patients were examined using a robotic tibial rotation device that mimicked the dial test. The data reported in this study is only from the healthy legs of these patients. Torque was applied through footplates and was measured using servomotors. Lower leg motion was measured at the foot using the motors. Tibial motion was also measured through an electromagnetic tracking system and a sensor on the proximal tibia. Load-deformation curves representing rotational motion of the foot and tibia were compared using Pearson's correlation coefficients. Off-axis motions including medial-lateral translation and anterior-posterior translation were also measured using the electromagnetic system.
The robotic device and electromagnetic system were able to provide axial rotation data and translational data for the tibia during the dial test. Motion measured at the foot was not correlated to motion of the tibial tubercle in internal rotation or in external rotation. The position of the tibial tubercle was 26.9° ± 11.6° more internally rotated than the foot at torque 0 Nm. Medial-lateral translation and anterior-posterior translation were combined to show the path of the tubercle in the coronal plane during tibial rotation.
The information captured during a manual dial test includes both rotation of the tibia and proximal tibia translation. All of this information can be captured using a robotic tibial axial rotation device with an electromagnetic tracking system. The pathway of the tibial tubercle during tibial axial rotation can provide additional information about knee instability without relying on side-to-side comparison between knees. The translation of the proximal tibia is important information that must be considered in addition to axial rotation of the tibia when performing a dial test whether done manually or with a robotic device. Instrumented foot position cannot provide the same information.
IV.
本研究的目的是：（1）确定机器人胫骨旋转装置和电磁跟踪系统能否在膝关节屈曲30°时准确重现临床表盘试验；（2）比较在机器人装置脚板处采集的旋转数据与使用胫骨近端电磁传感器测量的胫骨旋转数据。
使用模拟表盘试验的机器人胫骨旋转装置对32名单侧前交叉韧带重建患者进行检查。本研究报告的数据仅来自这些患者的健康腿。通过脚板施加扭矩，并使用伺服电机进行测量。使用电机在足部测量小腿运动。还通过电磁跟踪系统和胫骨近端的传感器测量胫骨运动。使用Pearson相关系数比较代表足部和胫骨旋转运动的载荷-变形曲线。还使用电磁系统测量包括内外平移和前后平移在内的离轴运动。
机器人装置和电磁系统能够在表盘试验期间为胫骨提供轴向旋转数据和平移数据。在足部测量的运动与胫骨结节在内旋或外旋时的运动不相关。在扭矩为0 Nm时，胫骨结节的位置比足部多内旋26.9°±11.6°。将内外平移和前后平移相结合，以显示胫骨旋转时结节在冠状面内的路径。
手动表盘试验期间采集的信息包括胫骨旋转和胫骨近端平移。所有这些信息都可以使用带有电磁跟踪系统的机器人胫骨轴向旋转装置来采集。胫骨轴向旋转时胫骨结节的路径可以提供有关膝关节不稳定的额外信息，而无需依赖膝关节之间的左右比较。在进行表盘试验时，无论是手动进行还是使用机器人装置，除了胫骨的轴向旋转外，胫骨近端的平移也是必须考虑的重要信息。仪器测量的足部位置无法提供相同的信息。
IV级。
