Lee Jeffrey Chun-Yin, Yung Patrick Shu-Hang, Lam Mak-Ham, Hung Aaron See-Long, Fong Daniel Tik-Pui, Chan Wood Yee, Chan Kai-Ming
Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Hong Kong, China.
Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2018 Dec 6;16:19-23. doi: 10.1016/j.asmart.2018.11.005. eCollection 2019 Apr.
Biomechanical measurement tools have been developed and widely used to precisely quantify knee anterior-posterior laxity after anterior cruciate ligament (ACL) injury. However, validated objective device to document knee rotational laxity, though being developed by different researchers, are not yet widely used in the daily clinical practice. A new biomechanical device was developed to quantify knee internal and external rotations.
The reliability of the new biomechanical device which measures knee rotations were tested. Different torques (1-10Nm) were applied by the device to internally and externally rotate human cadaveric knees, which were held in a flexion angle of 30°. The rotations were measured by the device in degrees. There were two independent testers, and each tester carried out three trials. Intra-rater and inter-rater reliability were quantified in terms of intraclass correlation (ICC) coefficient among trials and between testers. The device was verified by the comparison with a computer assisted navigation system. ICC was measured. Mean, standard deviation and 95% confident interval of the difference as well as the root mean square difference were calculated. The correlations were deemed to be reliable if the ICC was above 0.75.
The intra-rater and inter-rater reliability achieved high correlation for both internal and external rotation, ranged from 0.959 to 0.992. ICC between the proposed meter and the navigation system for both internal and external rotation was 0.78. The mean differences were 2.3° and 2.5° for internal and external rotation respectively.
A new knee rotational laxity meter was proposed in this study. Its reliability was verified by showing high correlation among trials. It also showed good correlation to a gold standard of measurement. It might be used to document knee rotational laxity for various purposes, especially after ACL injury, after further validation of the device in human subjects.
生物力学测量工具已得到开发并广泛用于精确量化前交叉韧带（ACL）损伤后膝关节的前后松弛度。然而，尽管不同研究人员开发了用于记录膝关节旋转松弛度的经过验证的客观设备，但在日常临床实践中尚未广泛使用。一种新的生物力学设备被开发出来用于量化膝关节的内旋和外旋。
测试了测量膝关节旋转的新型生物力学设备的可靠性。该设备对处于30°屈曲角度的人体尸体膝关节施加不同扭矩（1 - 10牛米）以进行内旋和外旋。旋转角度由该设备以度为单位进行测量。有两名独立的测试人员，每位测试人员进行三次试验。试验间和测试人员间的可靠性通过组内相关系数（ICC）进行量化。通过与计算机辅助导航系统比较来验证该设备。测量ICC。计算差异的均值、标准差和95%置信区间以及均方根差。如果ICC高于0.75，则认为相关性可靠。
测试人员内和测试人员间的可靠性在内旋和外旋方面均达到高度相关，范围为从到0.959至0.992。所提出的测量仪与导航系统在内旋和外旋方面的ICC均为0.78。内旋和外旋的平均差异分别为2.3°和2.5°。
本研究中提出了一种新型膝关节旋转松弛度测量仪。通过试验间的高度相关性验证了其可靠性。它与测量的金标准也显示出良好的相关性。在该设备在人体受试者中进一步验证后，它可能用于各种目的记录膝关节旋转松弛度，特别是在ACL损伤后。
