Murase Atsunori, Nozaki Masahiro, Kobayashi Masaaki, Goto Hideyuki, Yoshida Masahito, Yasuma Sanshiro, Takenaga Tetsuya, Nagaya Yuko, Mizutani Jun, Okamoto Hideki, Iguchi Hirotaka, Otsuka Takanobu
Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya 467-8601, Japan.
Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya 467-8601, Japan.
J Orthop Sci. 2017 Sep;22(5):874-879. doi: 10.1016/j.jos.2017.04.010. Epub 2017 May 27.
Recently several authors have reported on the quantitative evaluation of the pivot-shift test using cutaneous fixation of inertial sensors. Before utilizing this sensor for clinical studies, it is necessary to evaluate the accuracy of cutaneous sensor in assessing rotational knee instability. To evaluate the accuracy of inertial sensors, we compared cutaneous and transosseous sensors in the quantitative assessment of rotational knee instability in a cadaveric setting, in order to demonstrate their clinical applicability.
Eight freshly frozen human cadaveric knees were used in this study. Inertial sensors were fixed on the tibial tuberosity and directly fixed to the distal tibia bone. A single examiner performed the pivot shift test from flexion to extension on the intact knees and ACL deficient knees. The peak overall magnitude of acceleration and the maximum rotational angular velocity in the tibial superoinferior axis was repeatedly measured with the inertial sensor during the pivot shift test. Correlations between cutaneous and transosseous inertial sensors were evaluated, as well as statistical analysis for differences between ACL intact and ACL deficient knees.
Acceleration and angular velocity measured with the cutaneous sensor demonstrated a strong positive correlation with the transosseous sensor (r = 0.86 and r = 0.83). Comparison between cutaneous and transosseous sensor indicated significant difference for the peak overall magnitude of acceleration (cutaneous: 10.3 ± 5.2 m/s, transosseous: 14.3 ± 7.6 m/s, P < 0.01) and for the maximum internal rotation angular velocity (cutaneous: 189.5 ± 99.6 deg/s, transosseous: 225.1 ± 103.3 deg/s, P < 0.05), but no significant difference for the maximum external rotation angular velocity (cutaneous: 176.1 ± 87.3 deg/s, transosseous: 195.9 ± 106.2 deg/s, N.S).
There is a positive correlation between cutaneous and transosseous inertial sensors. Therefore, this study indicated that the cutaneous inertial sensors could be used clinically for quantifying rotational knee instability, irrespective of the location of utilization.
最近有几位作者报道了使用惯性传感器的皮肤固定法对轴移试验进行定量评估。在将这种传感器用于临床研究之前，有必要评估皮肤传感器在评估膝关节旋转不稳方面的准确性。为了评估惯性传感器的准确性，我们在尸体模型中比较了皮肤传感器和经骨传感器在定量评估膝关节旋转不稳方面的表现，以证明它们的临床适用性。
本研究使用了8个新鲜冷冻的人尸体膝关节。惯性传感器固定在胫骨结节上，并直接固定在胫骨远端骨上。由一名检查者对完整膝关节和前交叉韧带（ACL）损伤的膝关节进行从屈曲到伸展的轴移试验。在轴移试验期间，用惯性传感器反复测量胫骨上下轴的峰值总加速度和最大旋转角速度。评估了皮肤惯性传感器和经骨惯性传感器之间的相关性，以及ACL完整膝关节和ACL损伤膝关节之间差异的统计分析。
皮肤传感器测量的加速度和角速度与经骨传感器呈强正相关（r = 0.86和r = 0.83）。皮肤传感器和经骨传感器之间的比较表明，在峰值总加速度方面存在显著差异（皮肤传感器：10.3±5.2m/s，经骨传感器：14.3±7.6m/s，P < 0.01），在最大内旋角速度方面也存在显著差异（皮肤传感器：189.5±99.6°/s，经骨传感器：225.1±103.3°/s，P < 0.05），但在最大外旋角速度方面无显著差异（皮肤传感器：176.1±87.3°/s，经骨传感器：195.9±106.2°/s，无显著性差异）。
皮肤惯性传感器和经骨惯性传感器之间存在正相关。因此，本研究表明，无论使用位置如何，皮肤惯性传感器均可在临床上用于量化膝关节旋转不稳。
