PDF(Pubmed)
Abstract：
UNASSIGNED: Varus and valgus knee stress radiographs provide valuable information in the pre- and postoperative evaluation of joint laxity in patients with multiligament knee injuries (MLKIs).
UNASSIGNED: To review the literature for described techniques of quantifying laxity on coronal stress radiographs of the knee and identify the most reliable method.
UNASSIGNED: Cohort study (diagnosis); Level of evidence, 3.
UNASSIGNED: A thorough literature search using the MEDLINE and Embase databases identified 4 studies with distinct methods for objectively measuring laxity on varus and valgus stress radiographs: Heesterbeek et al (2008), Jacobsen (1976), LaPrade et al (2004), and Sawant et al (2004). To compare these methods, 200 coronal plane stress radiographs from 50 patients with MLKIs were retrospectively reviewed from an MLKI database at a single institution. The amount of varus and valgus laxity on each radiograph was measured independently by 4 reviewers using each method. Intraclass correlation coefficients (ICCs) with 95% CIs were calculated to assess the interobserver reliability of each method overall and the varus and valgus measurements individually.
UNASSIGNED: For all 4 methods, the overall interobserver reliability was considered at least moderate. The method by Heesterbeek et al proved to have the highest interrater reliability in all domains-overall (ICC, 0.87 [95% CI, 0.85-0.90]), valgus (ICC, 0.83 [95% CI, 0.78-0.88]), and varus (ICC, 0.87 [95% CI, 0.83-0.90])-demonstrating good to excellent reliability both overall and in varus measurements and showing good reliability in valgus measurements. The method by Sawant et al demonstrated good reliability in valgus measurements. All other measures demonstrated moderate reliability.
UNASSIGNED: Available methods for measuring knee joint laxity on varus and valgus knee stress radiographs in patients with MLKIs demonstrated moderate to good interobserver reliability. The method described by Heesterbeek et al proved to have the highest reliability overall as well as in measurements on varus and valgus views individually.
UNASSIGNED: To review the literature for described techniques of quantifying laxity on coronal stress radiographs of the knee and identify the most reliable method.
UNASSIGNED: Cohort study (diagnosis); Level of evidence, 3.
UNASSIGNED: A thorough literature search using the MEDLINE and Embase databases identified 4 studies with distinct methods for objectively measuring laxity on varus and valgus stress radiographs: Heesterbeek et al (2008), Jacobsen (1976), LaPrade et al (2004), and Sawant et al (2004). To compare these methods, 200 coronal plane stress radiographs from 50 patients with MLKIs were retrospectively reviewed from an MLKI database at a single institution. The amount of varus and valgus laxity on each radiograph was measured independently by 4 reviewers using each method. Intraclass correlation coefficients (ICCs) with 95% CIs were calculated to assess the interobserver reliability of each method overall and the varus and valgus measurements individually.
UNASSIGNED: For all 4 methods, the overall interobserver reliability was considered at least moderate. The method by Heesterbeek et al proved to have the highest interrater reliability in all domains-overall (ICC, 0.87 [95% CI, 0.85-0.90]), valgus (ICC, 0.83 [95% CI, 0.78-0.88]), and varus (ICC, 0.87 [95% CI, 0.83-0.90])-demonstrating good to excellent reliability both overall and in varus measurements and showing good reliability in valgus measurements. The method by Sawant et al demonstrated good reliability in valgus measurements. All other measures demonstrated moderate reliability.
UNASSIGNED: Available methods for measuring knee joint laxity on varus and valgus knee stress radiographs in patients with MLKIs demonstrated moderate to good interobserver reliability. The method described by Heesterbeek et al proved to have the highest reliability overall as well as in measurements on varus and valgus views individually.
摘要：
■内翻和外翻膝关节应力X光片在多韧带膝关节损伤（MLKIs）患者关节松弛的术前和术后评估中提供了有价值的信息。
■回顾文献，以描述在膝盖的冠状应力射线照片上量化松弛度的技术，并确定最可靠的方法。
■队列研究（诊断）；证据水平，3.
■使用MEDLINE和Embase数据库进行的全面文献检索确定了4项研究，这些研究采用了不同的方法来客观地测量内翻和外翻应力射线照相的松弛度：Heesterbeek等（2008），Jacobsen(1976)LaPrade等人(2004)，和Sawant等人(2004)。为了比较这些方法，从单个机构的MLKI数据库中回顾性审查了50例MLKIs患者的200张冠状平面应力X射线照片。每个X线片上的内翻和外翻松弛的量由4名审阅者使用每种方法独立测量。计算了具有95％CIs的组内相关系数（ICC），以评估每种方法的总体观察者间可靠性以及分别进行的内翻和外翻测量。
■对于所有4种方法，总体观察者间可靠性被认为至少中等.Heesterbeek等人的方法被证明在所有领域中具有最高的评分者间可靠性-总体(ICC，0.87[95%CI，0.85-0.90])，外翻(ICC，0.83[95%CI，0.78-0.88])，和varus(ICC，0.87[95％CI，0.83-0.90]）-在整体和内翻测量中均显示出良好的可靠性，并且在外翻测量中显示出良好的可靠性。Sawant等人的方法在外翻测量中证明了良好的可靠性。所有其他措施都显示出中等可靠性。
■在MLKIs患者的内翻和外翻膝关节应力X线片上测量膝关节松弛度的可用方法显示出中度至良好的观察者间可靠性。Heesterbeek等人描述的方法被证明具有最高的整体可靠性，以及在分别对内翻和外翻视图的测量中。
■回顾文献，以描述在膝盖的冠状应力射线照片上量化松弛度的技术，并确定最可靠的方法。
■队列研究（诊断）；证据水平，3.
■使用MEDLINE和Embase数据库进行的全面文献检索确定了4项研究，这些研究采用了不同的方法来客观地测量内翻和外翻应力射线照相的松弛度：Heesterbeek等（2008），Jacobsen(1976)LaPrade等人(2004)，和Sawant等人(2004)。为了比较这些方法，从单个机构的MLKI数据库中回顾性审查了50例MLKIs患者的200张冠状平面应力X射线照片。每个X线片上的内翻和外翻松弛的量由4名审阅者使用每种方法独立测量。计算了具有95％CIs的组内相关系数（ICC），以评估每种方法的总体观察者间可靠性以及分别进行的内翻和外翻测量。
■对于所有4种方法，总体观察者间可靠性被认为至少中等.Heesterbeek等人的方法被证明在所有领域中具有最高的评分者间可靠性-总体(ICC，0.87[95%CI，0.85-0.90])，外翻(ICC，0.83[95%CI，0.78-0.88])，和varus(ICC，0.87[95％CI，0.83-0.90]）-在整体和内翻测量中均显示出良好的可靠性，并且在外翻测量中显示出良好的可靠性。Sawant等人的方法在外翻测量中证明了良好的可靠性。所有其他措施都显示出中等可靠性。
■在MLKIs患者的内翻和外翻膝关节应力X线片上测量膝关节松弛度的可用方法显示出中度至良好的观察者间可靠性。Heesterbeek等人描述的方法被证明具有最高的整体可靠性，以及在分别对内翻和外翻视图的测量中。
