TY - JOUR
T1 - Combined anterior and rotational knee laxity measurements improve the diagnosis of anterior cruciate ligament injuries
AU - Mouton, C.
AU - Theisen, D.
AU - Meyer, T.
AU - Agostinis, H.
AU - Nührenbörger, C.
AU - Pape, D.
AU - Seil, R.
N1 - Funding Information:
The present project has been supported by the National Research Fund, Luxembourg (1084312). The authors thank Prof. Stefan Maas from the University of Luxembourg for the collaboration in the development of the Rotameter and the Oeuvre Nationale de Secours Grande Duchesse Charlotte, Luxembourg, for the support of the ACL injury evaluation programme.
Publisher Copyright:
© 2015, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
PY - 2015/10/26
Y1 - 2015/10/26
N2 - Purpose: This study analysed whether associating the side-to-side difference in displacement and the slope of the load–displacement curve of anterior and rotational knee laxity measurements would improve the instrumental diagnosis of anterior cruciate ligament (ACL) ruptures and help to detect different types of ACL tears. Methods: Anterior and rotational knee laxity was measured in 128 patients with an arthroscopically confirmed ACL injury and 104 healthy controls. Side-to-side differences were determined for three variables in anterior laxity: anterior displacement at 200 N (ATD200), primary compliance from 30 to 50 N (PCA) and secondary compliance from 100 to 200 N (SCA). Furthermore, four variables in rotational laxity were considered: internal and external rotation at 5 N m (IR5/ER5) and compliance from 2 to 5 N m (CIR/CER). Receiver operating characteristic curves allowed to determine thresholds, specificities and sensitivities to detect ACL lesions, based on single variables considered and combinations thereof. Results: Sensitivity and specificity reached, respectively, 75 and 95 % for ATD200 (threshold: 1.2 mm) and 38 and 95 % for IR5 (threshold: 3.2°). If either two out of the three variables were positive for anterior laxity or both IR5 and CIR were positive, 81 % of patients were identified without a false positive. All patients for whom ATD200 was >3.7 mm, PCA > 48 μm/N or SCA > 17.5 µm/N had ACL remnants that were either totally resorbed or healed on the posterior cruciate ligament. Conclusion: Combined instrumented anterior and rotational knee laxity measurements have excellent diagnostic value for ACL injury, provided that several measurements be considered concomitantly. Level of evidence: Diagnostic study, Level III.
AB - Purpose: This study analysed whether associating the side-to-side difference in displacement and the slope of the load–displacement curve of anterior and rotational knee laxity measurements would improve the instrumental diagnosis of anterior cruciate ligament (ACL) ruptures and help to detect different types of ACL tears. Methods: Anterior and rotational knee laxity was measured in 128 patients with an arthroscopically confirmed ACL injury and 104 healthy controls. Side-to-side differences were determined for three variables in anterior laxity: anterior displacement at 200 N (ATD200), primary compliance from 30 to 50 N (PCA) and secondary compliance from 100 to 200 N (SCA). Furthermore, four variables in rotational laxity were considered: internal and external rotation at 5 N m (IR5/ER5) and compliance from 2 to 5 N m (CIR/CER). Receiver operating characteristic curves allowed to determine thresholds, specificities and sensitivities to detect ACL lesions, based on single variables considered and combinations thereof. Results: Sensitivity and specificity reached, respectively, 75 and 95 % for ATD200 (threshold: 1.2 mm) and 38 and 95 % for IR5 (threshold: 3.2°). If either two out of the three variables were positive for anterior laxity or both IR5 and CIR were positive, 81 % of patients were identified without a false positive. All patients for whom ATD200 was >3.7 mm, PCA > 48 μm/N or SCA > 17.5 µm/N had ACL remnants that were either totally resorbed or healed on the posterior cruciate ligament. Conclusion: Combined instrumented anterior and rotational knee laxity measurements have excellent diagnostic value for ACL injury, provided that several measurements be considered concomitantly. Level of evidence: Diagnostic study, Level III.
KW - Anterior cruciate ligament
KW - Anterior knee laxity
KW - Combined laxity measurements
KW - Injury diagnosis
KW - Rotational knee laxity
UR - http://www.scopus.com/inward/record.url?scp=84942295819&partnerID=8YFLogxK
UR - https://www.ncbi.nlm.nih.gov/pubmed/26318487
U2 - 10.1007/s00167-015-3757-7
DO - 10.1007/s00167-015-3757-7
M3 - Article
C2 - 26318487
AN - SCOPUS:84942295819
SN - 0942-2056
VL - 23
SP - 2859
EP - 2867
JO - Knee Surgery, Sports Traumatology, Arthroscopy
JF - Knee Surgery, Sports Traumatology, Arthroscopy
IS - 10
ER -