■膝盖的前内侧旋转不稳定(AMRI)是由于前十字韧带和/或内侧副韧带受伤而引起的复杂而严重的状况。涉及AMRI的临床研究很少,客观的测量是不存在的。
■这项研究的目标是,首先,使用无创图像分析软件量化健康个体的前内侧旋转膝关节松弛度,第二,评估测量膝关节前内侧平移(AMT)的评分内和评分间可靠性和等效性。假设AMT可以使用非侵入性图像分析软件可靠地量化。
■队列研究;证据水平,3.
■这项前瞻性概念验证研究包括年龄在16至40岁之间、无膝关节损伤或手术史的健康个体。将三个粘合表面标记放置在膝盖内侧的预定界标上。三名独立研究人员在不同的胫骨旋转中通过前抽屉测试检查了前内侧旋转膝关节松弛度(中性胫骨旋转,胫骨外旋转15°,和胫骨内部旋转15°)。记录每个膝盖的整个检查,和AMT包括侧对侧差异(SSD)使用免费提供和验证的图像分析软件(PIVOTiPad应用程序)进行评估.使用单向方差分析和Bonferroni调整的事后分析进行组比较。计算组内相关系数(ICC)以评估AMT测量的内部和内部可靠性。使用2个单侧t检验程序评估测量的等效性。
■在15名参与者(53%为男性)的30个膝盖中评估了前内侧旋转性膝关节松弛,平均年龄为26.2±3.5岁。在所有三个评估者中,在中性胫骨旋转中观察到最高的AMT(均值范围,2.2-3.0mm),其次是胫骨外部旋转(手段范围,2.0-2.4毫米)和胫骨内部旋转(手段范围,1.8-2.2mm;P<.05)。AMT的内部可靠性(ICC,0.88-0.96)和SSD(ICC,0.61-0.96)测量结果良好到优秀,中等到优秀,分别。然而,AMT的评分者间可靠性差到中等(ICC,0.44-0.73)和SSD(ICC,0.12-0.69)测量。在几乎所有测试条件下,在评估者之间和内部都观察到AMT和SSD测量的统计学上的等效性。
■可以使用非侵入性图像分析软件量化前内侧旋转膝关节松弛,在未受伤的个体中,中性胫骨旋转期间观察到最高的AMT。在评估者内部,测量的可靠性和等效性良好,在评估者之间中等。
UNASSIGNED: Anteromedial rotatory instability (AMRI) of the knee is a complex and severe condition caused by injury to the anterior cruciate ligament and/or the medial collateral ligament. Clinical studies dealing with AMRI are rare, and objective measurements are nonexistent.
UNASSIGNED: The objectives of this study were, first, to quantify anteromedial rotatory knee
laxity in healthy individuals using a noninvasive image analysis software and, second, to assess intra- and interrater reliability and equivalence in measuring anteromedial knee translation (AMT). It was hypothesized that AMT could be reliably quantified using a noninvasive image analysis software.
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: This prospective proof-of-concept study included healthy individuals aged 16 to 40 years with no history of knee injury or surgery. Three adhesive surface markers were placed on predefined landmarks on the medial side of the knee. Three independent investigators examined anteromedial rotatory knee
laxity with an anterior drawer test in different tibial rotations (neutral tibial rotation, 15° of external tibial rotation, and 15° of internal tibial rotation). The entire examination of each knee was recorded, and AMT including the side-to-side difference (SSD) was assessed using a freely available and validated image analysis software (PIVOT iPad application). Group comparisons were performed using a 1-way analysis of variance with Bonferroni-adjusted post hoc analysis. Intraclass correlation coefficients (ICCs) were calculated to assess inter- and intrarater reliability of AMT measurements. Equivalence of measurements was evaluated using the 2 one-sided t-test procedure.
UNASSIGNED: Anteromedial rotatory knee
laxity was assessed in 30 knees of 15 participants (53% male) with a mean age of 26.2 ± 3.5 years. In all 3 raters, the highest AMT was observed in neutral tibial rotation (range of means, 2.2-3.0 mm), followed by external tibial rotation (range of means, 2.0-2.4 mm) and internal tibial rotation (range of means, 1.8-2.2 mm; P < .05). Intrarater reliability of AMT (ICC, 0.88-0.96) and SSD (ICC, 0.61-0.96) measurements was good to excellent and moderate to excellent, respectively. However, interrater reliability was poor to moderate for AMT (ICC, 0.44-0.73) and SSD (ICC, 0.12-0.69) measurements. Statistically significant equivalence of AMT and SSD measurements was observed between and within raters for almost all testing conditions.
UNASSIGNED: Anteromedial rotatory knee
laxity could be quantified using a noninvasive image analysis software, with the highest AMT observed during neutral tibial rotation in uninjured individuals. Reliability and equivalence of measurements were good to excellent within raters and moderate between raters.