Department of Orthopedics, Huashan Hospital, Fudan University, Jingan District, Shanghai, China.
J Orthop Surg Res. 2022 May 23;17(1):287. doi: 10.1186/s13018-022-03177-3.
Arthrometry has been introduced to evaluate the laxity of ankle joint in recent years. However, its role in the diagnosis of chronic ankle instability is still debatable. Therefore, we assessed the diagnostic accuracy of a digital arthrometer in terms of sensitivity and specificity.
According to the inclusion and exclusion criteria proposed by the International Ankle Consortium, we recruited 160 uninjured ankles (control group) and 153 ankles with chronic ankle instability (CAI group). Ankle laxity was quantitively measured by a validated digital arthrometer. Data of loading force and joint displacement were recorded in a continuous manner. Differences between the control and CAI groups were compared using 2-tailed independent t test. A receiver operating characteristic curve analysis was used to calculate area under a curve, sensitivity and specificity.
Load-displacement curves of the two groups were depicted. Differences of joint displacement between the control and CAI groups were compared at 30, 45, 60, 75, 90, 105 and 120 N, which were all of statistical significance (all p < 0.001) with the largest effect size at 90 N. Statistical significance was found in the differences between the two groups in load-displacement ratio at 10-120 N, 10-40 N, 40-80 N and 80-120 N (all p < 0.001), with the largest effect size at 10-40 N. Load-displacement ratio at the interval of 10-40 N had the highest area under a curve (0.9226), with sensitivity and specificity of 0.804 and 0.863, respectively, when the cutoff point was 0.1582 mm/N.
The digital arthrometer measurement could quantitively analyze the ankle laxity with high diagnostic accuracy. The load-displacement ratio would be a reliable and promising approach for chronic ankle instability diagnosis. Level of evidence level II.
近年来，关节测量已被引入用于评估踝关节的松弛度。然而，其在慢性踝关节不稳定诊断中的作用仍存在争议。因此，我们评估了数字关节测量仪的诊断准确性，包括敏感性和特异性。
根据国际踝关节联合会提出的纳入和排除标准，我们招募了 160 例无损伤踝关节（对照组）和 153 例慢性踝关节不稳定（CAI 组）患者。使用经过验证的数字关节测量仪定量测量踝关节松弛度。连续记录加载力和关节位移数据。使用双侧独立 t 检验比较对照组和 CAI 组之间的差异。使用受试者工作特征曲线分析计算曲线下面积、敏感性和特异性。
描绘了两组的负荷-位移曲线。比较了对照组和 CAI 组在 30、45、60、75、90、105 和 120 N 时的关节位移差异，所有差异均具有统计学意义（均 p<0.001），其中在 90 N 时的效应量最大。在 10-120 N、10-40 N、40-80 N 和 80-120 N 时，两组之间的负荷-位移比也存在统计学差异（均 p<0.001），其中在 10-40 N 时的效应量最大。在 10-40 N 时的负荷-位移比曲线下面积最高（0.9226），当截距点为 0.1582 mm/N 时，敏感性和特异性分别为 0.804 和 0.863。
数字关节测量仪测量可定量分析踝关节松弛度，具有较高的诊断准确性。负荷-位移比可能是慢性踝关节不稳定诊断的一种可靠且有前途的方法。证据等级为 II 级。
