Benvenuti J F, Vallotton J A, Meystre J L, Leyvraz P F
Hôpital Orthopédique de la Suisse Romande, Lausanne, Switzerland.
Knee Surg Sports Traumatol Arthrosc. 1998;6(4):215-9. doi: 10.1007/s001670050102.
The purpose of this study was to compare three types of objective measurement in Lachman test position and to validate a new measurement procedure. Twenty-three patients were evaluated after anterior cruciate ligament (ACL) reconstruction at 10 years' mean follow-up. The contralateral knee had a normal ACL. Both knees were compared using Lachman test, arthrometer, radiological drawer, and electromagnetic sensing device (EMS) measurements. The values were obtained by two trained orthopaedic surgeons independently. Arthrometer assessment was done with the Kneelax 3 (Biodex) at 88 and 132 N. Radiological drawer was measured with a load of 10 kg. EMS is composed of an electromagnetic transmitter and two sensors. Displacement of the sensors was measured along the three perpendicular axes of the transmitter. Data after processing give the displacement of the sensors perpendicular to the tibial axis. The load was applied on the calf perpendicular to the tibial axis with a 10-kg counter-weight. Metallic objects must be avoided around the set-up. No significant difference between examiners was observed in clinical (P = 0.45) or objective (P > 0.3) measurements. The best correlation was obtained between arthrometer and EMS measurements (R = 0.94). Arthrometric and radiological drawer were poorly correlated (R = 0.65). The values of the medial radiological drawer were quantitatively similar to the 132 N arthrometric values. The sensitivity of EMS to skin movements was tested. The correlation between the EMS drawer and the other movements was not significant (R < or = 0.37). Quantitative correspondence with Lachman grades was only 36% of the arthrometer and EMS values and 37% of the radiological measurements. The effectiveness of EMS to evaluate anterior tibial displacement in Lachman test position after ACL reconstruction is demonstrated in this study. This method is non-invasive and comfortable for the patient, but needs a careful set-up. This method can potentially be used to assess rotational laxities.
本研究的目的是比较拉赫曼试验位置的三种客观测量方法，并验证一种新的测量程序。对23例患者在平均随访10年的前交叉韧带（ACL）重建术后进行评估。对侧膝关节的ACL正常。使用拉赫曼试验、关节测量仪、放射学抽屉试验和电磁感应装置（EMS）测量对双膝进行比较。这些值由两名经过培训的骨科医生独立获取。使用Kneelax 3（Biodex）关节测量仪在88 N和132 N下进行评估。放射学抽屉试验在10 kg负荷下进行测量。EMS由一个电磁发射器和两个传感器组成。沿着发射器的三个垂直轴测量传感器的位移。处理后的数据给出传感器垂直于胫骨轴的位移。使用10 kg配重垂直于胫骨轴施加在小腿上。在装置周围必须避免金属物体。在临床测量（P = 0.45）或客观测量（P > 0.3）中，未观察到检查者之间存在显著差异。关节测量仪和EMS测量之间的相关性最佳（R = 0.94）。关节测量和放射学抽屉试验的相关性较差（R = 0.65）。内侧放射学抽屉试验的值在数量上与132 N关节测量值相似。测试了EMS对皮肤运动的敏感性。EMS抽屉试验与其他运动之间的相关性不显著（R≤0.37）。与拉赫曼分级的定量对应仅为关节测量仪和EMS值的36%以及放射学测量值的37%。本研究证明了EMS在评估ACL重建后拉赫曼试验位置的胫骨前移方面的有效性。该方法对患者是非侵入性的且舒适，但需要仔细设置。该方法有可能用于评估旋转松弛度。
