Andrade Renato, Gomes Eluana, Valente Cristina, Pereira Bruno, Macedo Carlos, Pereira Rogério, Vilas-Boas João Paulo, Niek van Dijk C, Espregueira-Mendes João
Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal.
Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal.
J ISAKOS. 2025 Jun;12:100851. doi: 10.1016/j.jisako.2025.100851. Epub 2025 Mar 20.
The purpose of this study was to assess the reliability of a new arthrometer - the Porto Ankle Testing Device (PATD) - that is compatible with magnetic resonance imaging (MRI) assessment to measure ankle joint laxity.
This cross-sectional study enrolled 33 ankles without a history of sprain or symptoms of instability. All ankles underwent ankle instrumented stress testing with the PATD with concurrent MRI. The PATD protocol compares the ankle rest position against the ankle stress under the anterolateral drawer or the talar tilt test. Tibiotalar and subtalar laxity measurements were calculated as the difference in joint position before and after stress testing. Tibiotalar laxity measurements included the anterior talus translation (ATT) and the talar tilt (TT). The ATT was measured in the anterior, diagonal, and inferior directions. Subtalar laxity measurements included anterior calcaneus translation (ACT), the subtalar tilt (STT), the subtalar opening distance, and the subtalar rotation. The intraclass correlation coefficient (ICC) was computed to evaluate the inter and intra-rater reliability, and the standard error measurement (SEM) to estimate the amount of random error associated with laxity measurements.
All tibiotalar and subtalar laxity measurements were classified as excellent reliability for inter (ICC, 0.77-0.98) and intra-rater (ICC, 0.87-0.99). Only the ATT in the inferior direction showed suboptimal inter-rater reliability (ICC, 0.59-0.70). The SEM values showed a low risk of associated random error from measurement and were higher for inter-rater than for repeated measures, suggesting that repeated measures result in a lower risk of random error.
The measurement of tibiotalar and subtalar laxity with the PATD provides excellent reliability between different assessors and after repeated measures. The PATD can overcome the limitations of previous devices while offering the correlation of structural integrity with a reliable assessment of functional competence of ankle ligaments (joint laxity) within the same exam.
Level IV.
本研究旨在评估一种新型关节测量仪——波尔图踝关节测试装置（PATD）的可靠性，该装置与磁共振成像（MRI）评估兼容，用于测量踝关节松弛度。
这项横断面研究纳入了33个无扭伤史或不稳定症状的踝关节。所有踝关节均使用PATD进行踝关节仪器化应力测试，并同时进行MRI检查。PATD方案将踝关节休息位与前外侧抽屉试验或距骨倾斜试验下的踝关节应力进行比较。胫距关节和距下关节松弛度测量值计算为应力测试前后关节位置的差异。胫距关节松弛度测量包括距骨前移位（ATT）和距骨倾斜（TT）。ATT在前后、斜向和下方方向进行测量。距下关节松弛度测量包括跟骨前移位（ACT）、距下关节倾斜（STT）、距下关节开口距离和距下关节旋转。计算组内相关系数（ICC）以评估评估者间和评估者内的可靠性，并计算标准误差测量值（SEM）以估计与松弛度测量相关的随机误差量。
所有胫距关节和距下关节松弛度测量在评估者间（ICC，0.77 - 0.98）和评估者内（ICC，0.87 - 0.99）的可靠性均被归类为优秀。仅下方方向的ATT显示评估者间可靠性欠佳（ICC，0.59 - 0.70）。SEM值显示测量相关随机误差风险较低，且评估者间的SEM值高于重复测量，表明重复测量导致随机误差风险较低。
使用PATD测量胫距关节和距下关节松弛度在不同评估者之间以及重复测量后具有出色的可靠性。PATD可以克服先前装置的局限性，同时在同一检查中提供结构完整性与踝关节韧带功能能力（关节松弛度）可靠评估之间的相关性。
四级。
