van Eijck Sander C, Vugts Marly M J, Janssen Rob P A, Hoogendoorn Iris, Ito Keita, van der Steen Maria C
Department of Orthopedic Surgery & Trauma Máxima Medical Center Veldhoven The Netherlands.
Orthopedic Biomechanics, Department of Biomedical Engineering Eindhoven University of Technology Veldhoven The Netherlands.
J Exp Orthop. 2024 Jul 24;11(3):e12094. doi: 10.1002/jeo2.12094. eCollection 2024 Jul.
Knee laxity can be experienced as knee instability which may lead to a limitation in the activity of patients. Current methods to determine knee instability are performed in a static setting, which does not always correlate with dynamic knee laxity during activities. Wearables might be able to measure knee laxity in a dynamic setting and could be of added value in the diagnosis and treatment of excessive knee laxity. Therefore, the aim of this systematic review is to provide an overview of the wearables that have been developed and their ability to measure knee laxity during dynamic activities.
The PRISMA guidelines for systematic reviews were followed. A literature search was conducted in EMBASE, PubMed and Cochrane databases. Included studies assessed patients with knee instability using a non-invasive wearable sensor system during dynamic activity, with comparison to a reference system or healthy knees. Data extraction was performed by two authors via a predefined format. The risk of bias was assessed by The Dutch checklist for diagnostic tests.
A total of 4734 articles were identified. Thirteen studies were included in the review. The studies showed a great variety of patients, sensor systems, reference tests, outcome measures and performed activities. Nine of the included studies were able to measure differences in patients with knee instability, all including a tri-axial accelerometer. Differences were not measurable in all parameters and activities in these studies.
Wearables, including at least a tri-axial accelerometer, seem promising for measuring dynamic knee laxity in the anterior-posterior and mediolateral direction. At this stage, it remains unclear if the measured outcomes completely reflect the knee instability that patients experience in daily life.
Level III.
膝关节松弛可表现为膝关节不稳定，这可能会限制患者的活动。目前确定膝关节不稳定的方法是在静态环境下进行的，这并不总是与活动期间的动态膝关节松弛相关。可穿戴设备或许能够在动态环境下测量膝关节松弛，并且在膝关节过度松弛的诊断和治疗中可能具有附加价值。因此，本系统评价的目的是概述已开发的可穿戴设备及其在动态活动期间测量膝关节松弛的能力。
遵循系统评价的PRISMA指南。在EMBASE、PubMed和Cochrane数据库中进行文献检索。纳入的研究在动态活动期间使用非侵入性可穿戴传感器系统评估膝关节不稳定的患者，并与参考系统或健康膝关节进行比较。由两名作者通过预定义格式进行数据提取。通过荷兰诊断试验检查表评估偏倚风险。
共识别出4734篇文章。13项研究纳入本评价。这些研究显示了患者、传感器系统、参考测试、结局指标和所进行活动的多样性。纳入的研究中有9项能够测量膝关节不稳定患者的差异，所有研究均包括三轴加速度计。在这些研究的所有参数和活动中，差异并非都可测量。
包括至少一个三轴加速度计的可穿戴设备，在测量前后方向和内外侧方向的动态膝关节松弛方面似乎很有前景。在现阶段，尚不清楚所测量的结果是否完全反映了患者在日常生活中所经历的膝关节不稳定。
三级。
