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Magdič M, Dahmane RG, Vauhnik R. Intra-rater reliability of the knee arthrometer GNRB® for measuring knee anterior laxity in healthy, active subjects. J Orthop 2023; 39:7-10. [PMID: 37089624 PMCID: PMC10113708 DOI: 10.1016/j.jor.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/22/2023] [Accepted: 03/31/2023] [Indexed: 04/25/2023] Open
Abstract
Background Arthrometers are used to assess knee anterior laxity and to evaluate the integrity of the anterior cruciate ligament. Assessment of knee anterior laxity is crucial part of the clinical examination. The aim of this study was to investigate the intra-rater reliability of the GNRB® in healthy subjects. Methods In the study participated 97 subjects and two measurements using a GNRB® arthrometer were performed. Males were tested two times one week a part. Females were tested two times within 24 h. Measurements were performed at the following forces 134 N, 134 N, 150 N, 200 N, and 200 N. To evaluate the reliability of GNRB® measurements an intraclass correlation coefficient was calculated. Results Intra-rater reliability of the GNRB® measurements is good for 134 N on the left knee (ICC = 0.848) and the right knee (ICC = 0.788) and for 200 N on the left knee (ICC = 0.805) and the right knee (ICC = 0.756). Conclusion The GNRB® knee arthrometer has good intra-reliability for measurements at the 134 N and 200 N forces. Reliability can be increased with the standardize position of the subject, the stabilization of the patella and standardize measurement protocol.
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Affiliation(s)
- Miha Magdič
- Faculty of Health Sciences - Department of Physiotherapy, University of Ljubljana, Zdravstvena pot 5, Ljubljana, Slovenia
| | - Raja Gošnak Dahmane
- Chair of Biomedicine, Faculty of Health Sciences, University of Ljubljana, Zdravstvena pot 5, Ljubljana, Slovenia
| | - Renata Vauhnik
- Faculty of Health Sciences - Department of Physiotherapy, University of Ljubljana, Zdravstvena pot 5, Ljubljana, Slovenia
- Arthron, Institute for Joint and Sports Injuries, Ukmarjeva 2, Ljubljana, Slovenia
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Smith K, Miller N, Laslovich S. The Reliability of the GNRB® Knee Arthrometer in Measuring ACL Stiffness and Laxity: Implications for Clinical Use and Clinical Trial Design. Int J Sports Phys Ther 2022; 17:1016-1025. [PMID: 36237656 PMCID: PMC9528678 DOI: 10.26603/001c.38252] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/25/2022] [Indexed: 11/05/2022] Open
Abstract
Background Stability of the knee is dependent on multiple factors including integrity of the anterior cruciate ligament (ACL). Greater knee joint laxity appears to negatively affect dynamic joint function and therefore reliable and valid measures of ACL stiffness and laxity are clinically valuable. Purpose The aim of this study was to investigate the reliability of the GENOUROB, (GNRB®) knee arthrometer device in measuring both stiffness and laxity of the ACL, and to provide information on sample size calculation for future clinical trials. Study Design Cross-sectional test-retest study. Method Twelve healthy student participants (age 24-30 years; 6 females and 6 males) completed testing on two different testing dates. Anterior tibial translation and stiffness were measured using the GNRB® device at forces of 134N and 200N. Reliability analyses were performed using intraclass correlation coefficients (ICC). SEM, MDC, and sample size calculations were also determined. Results Average anterior tibial displacements of 3.63mm and 5.32mm were found for 134N and 200N of force respectively. ICC values for intra-rater, inter-rater, and test-retest reliability were similar across measures of anterior tibial translation and stiffness, ranging from .72 to .83 (95% CI: .54 to .90). The standard error of measurement (SEM) for anterior tibial stiffness ranged from 3.47 mm/N to 3.76 mm/N. Minimal detectable change (MDC) for test-retest anterior tibial stiffness was 9.6 mm/N. Sample sizes for crossover and parallel design studies were determined. Conclusion ACL laxity and stiffness measures were found to be reliably obtainable using the GNRB® knee arthrometer under the strict control of the individual's alignment to the device and patellar pad forces. Reliable laxity and stiffness values may assist practitioners in clinical reasoning and the development of individualized ACL rehabilitation programs. Additionally, the sample size calculations presented may aid in future research design. Level of Evidence 3.
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Affiliation(s)
- Kayla Smith
- Physical Therapy, University of St. Augustine for Health Sciences
| | - Nicole Miller
- Physical Therapy, University of St. Augustine for Health Sciences
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3
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Nuccio S, Labanca L, Rocchi JE, Mariani PP, Sbriccoli P, Macaluso A. Altered Knee Laxity and Stiffness in Response to a Soccer Match Simulation in Players Returning to Sport Within 12 Months After Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2021; 49:2150-2158. [PMID: 34038185 DOI: 10.1177/03635465211013020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The acute effects of exercise on anterior knee laxity (AKL) and anterior knee stiffness (AKS) have been documented in healthy participants, but only limited evidence has been provided for athletes cleared to return to sports after anterior cruciate ligament (ACL) reconstruction (ACLR). PURPOSE/HYPOTHESIS The purpose was to determine if 45 minutes of a soccer match simulation lead to acute changes in AKL and AKS in soccer players returning to sport within 12 months after ACLR. We hypothesized that the reconstructed knee of the ACLR group would exhibit an altered response to sport-specific exercise. STUDY DESIGN Controlled laboratory study. METHODS A total of 13 soccer players cleared to return to sport after ACLR and 13 healthy control soccer players matched for age, physical activity level, limb dominance, and anthropometric characteristics were recruited. To assess the effects of a standardized soccer match simulation (Soccer Aerobic Field Test [SAFT45]) on AKL and AKS, an arthrometric evaluation was carried out bilaterally before and immediately after SAFT45. To conduct a comprehensive examination of the force-displacement curve, the absolute and side-to-side difference (SSD) values of both AKL and AKS were extracted at 67, 134, and 200 N. RESULTS The ACLR and control groups showed similar AKL and AKS at baseline (P > .05). In response to SAFT45, laxity increased bilaterally at all force levels by 14% to 17% only in the control group (P < .025). Similarly, AKS at 134 and 200 N decreased in response to SAFT45 only in the control group (10.5% and 20.5%, respectively; P < .025). After SAFT45, the ACLR group had 1.9 and 2.5 times higher SSDs of AKS at 67 and 134 N compared with the control group, respectively (P < .025), as well as a 1.9 times higher SSD of AKS at 134 N compared with baseline (P = .014). CONCLUSION Soccer players at the time of return to sport after ACLR showed an altered mechanical response to a sport-specific match simulation consisting of bilaterally unchanged AKL and AKS. CLINICAL RELEVANCE Soccer players showing altered AKL and AKS in response to exercise after ACLR may not be ready to sustain their preinjury levels of sport, thus potentially increasing the risk of second ACL injuries.
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Affiliation(s)
- Stefano Nuccio
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Luciana Labanca
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Jacopo Emanuele Rocchi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.,Villa Stuart Sport Clinic, Rome, Italy
| | - Pier Paolo Mariani
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.,Villa Stuart Sport Clinic, Rome, Italy
| | - Paola Sbriccoli
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.,Villa Stuart Sport Clinic, Rome, Italy
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Klasan A, Putnis SE, Kandhari V, Oshima T, Parker DA. Anterior knee translation measurements after ACL reconstruction are influenced by the type of laximeter used. Knee Surg Sports Traumatol Arthrosc 2020; 28:3639-3646. [PMID: 32240345 DOI: 10.1007/s00167-020-05950-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 03/23/2020] [Indexed: 01/12/2023]
Abstract
PURPOSE Laximeters were designed to diagnose an anterior cruciate ligament (ACL) deficient knee, but their use has now focused on providing an objective assessment of the anterior translation (AT) of an intact and ACL-reconstructed knee. In this study we report the introduction and direct comparison of an automated and computerized AT measurement device, GNRB, with the device previously established by the institute and as the current literature standard, the KT1000. METHODS A prospective data collection was commenced upon introduction of the GNRB. The measurements of AT in each patient were performed by the same investigator with each device using 134 N applied to both knees, giving a side-to-side difference. The investigators were a sport scientist, a biomechanical engineer and a physiotherapist. Increased AT was defined as a difference > 3 mm. RESULTS Three investigators performed the measurements in 122 patients, 9.8 (± 1.8) months after ACL reconstruction. Mean AT of the healthy knee was 5.7 mm with KT1000 and 4.4 mm with GNRB (p = 0.002). Mean AT of the ACL reconstructed knee was 7.0 mm with the KT1000 and 5.3 mm with the GNRB (p = 0.037). The KT1000 had a higher variance of results than the GNRB (p < 0.001). There were 25 patients with increased AT measured by KT1000 compared with 12 patients using the GNRB (p < 0.016), with only 5 on both devices. CONCLUSIONS GNRB has better consistency of results when compared to the KT1000. Both devices lack comparability for detecting increased AT, with the KT1000 recording a side-to-side difference of more than 3 mm in twice as many patients as the GNRB. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Antonio Klasan
- Sydney Orthopaedic Research Institute, Level 1, The Gallery, 445 Victoria Ave, Chatswood, NSW, 2067, Australia.
| | - Sven Edward Putnis
- Sydney Orthopaedic Research Institute, Level 1, The Gallery, 445 Victoria Ave, Chatswood, NSW, 2067, Australia
| | - Vikram Kandhari
- Sydney Orthopaedic Research Institute, Level 1, The Gallery, 445 Victoria Ave, Chatswood, NSW, 2067, Australia
| | - Takeshi Oshima
- Sydney Orthopaedic Research Institute, Level 1, The Gallery, 445 Victoria Ave, Chatswood, NSW, 2067, Australia
| | - David Anthony Parker
- Sydney Orthopaedic Research Institute, Level 1, The Gallery, 445 Victoria Ave, Chatswood, NSW, 2067, Australia
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Mouarbes D, Cavaignac E, Chiron P, Bérard E, Murgier J. Evaluation of reproducibility of robotic knee testing device (GNRB) on 60 healthy knees. J Orthop 2018; 15:94-98. [PMID: 29657447 DOI: 10.1016/j.jor.2018.01.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 01/14/2018] [Indexed: 11/27/2022] Open
Abstract
Introduction There is a main concern about the usefulness and the accuracy of the different laximeters. The GnrB device is becoming more popular, but according to the literature it's not clear whether it is fully reliable. Objective GNRB laxity measurements are not reproducible for measurement of anterior translation of the tibia. Material and methods We analyzed the reproducibility of GNRB measurements in healthy subjects by the Test-Retest method in 2 sessions. Results 30 pairs of healthy knees were assessed. Test-Retest agreement was poor for both absolute values and for differentials at 134 and 200 N with an intra-class correlation ranging from 0.210 to 0.486. There was a significant differance in anterior tibial translation, in side-to-side difference, according to the patellar pressure. Conclusion The reproducibility is found to be poor under optimum conditions of comparability. The patellar pressure influences strongly thelaxity value.
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Affiliation(s)
- Dany Mouarbes
- Department of Orthopedic and Traumatology, CHU Toulouse, Toulouse, France
| | - Etienne Cavaignac
- Department of Orthopedic and Traumatology, CHU Toulouse, Toulouse, France
| | - Philippe Chiron
- Department of Orthopedic and Traumatology, CHU Toulouse, Toulouse, France
| | - Emilie Bérard
- Epidemiology Department, CHU Toulouse, Toulouse, France
| | - Jérôme Murgier
- Department of Orthopedic and Traumatology, CHU Toulouse, Toulouse, France
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Anterior tibial laxity using the GNRB® device in healthy knees. Knee 2018; 25:34-39. [PMID: 29307479 DOI: 10.1016/j.knee.2017.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 12/29/2016] [Accepted: 03/13/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND GRNB® is a non-radiating power tool that allows the evaluation of the anterior tibial translation. HYPOTHESIS The pressure exerted by the system against the patella and the body mass index (BMI) could affect the anterior tibial translation when we repeat the measurements in healthy knees. MATERIALS AND METHODS We retrospectively evaluated the measurements of anterior knee laxity in healthy knees carried out by the GNRB® in 69 consecutive patients who underwent anterior cruciate ligament (ACL) repair in the contralateral knee. Two measurements were carried out, the initial measurements (M1), and then repeated at a mean of seven months (M2) (4.9 to 13months). RESULTS There were 38 women and 31 men with an average age of 31years. In healthy knees, the Mean average anterior translation was 5.4±4mm with an average patellar force of 35.8 at time M1. The average anterior translation was 4.9±4mm with an average patellar force of 47 at time M2. There was a significant difference between the measurements M1 and M2 (P<0.03). The tightening force was significantly different between the two sets of measurements (P<10-7). There was a negative correlation between the pressure applied on the patella and anterior knee laxity (P<0.01). CONCLUSION The pressure force exerted on the patella during GNRB® affects the measurement of anterior laxity in healthy knees. This raises the problem of the reproducibility of the measurements during repeated examinations at different times.
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Rohman EM, Macalena JA. Anterior cruciate ligament assessment using arthrometry and stress imaging. Curr Rev Musculoskelet Med 2016; 9:130-8. [PMID: 26984335 DOI: 10.1007/s12178-016-9331-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Arthrometry and stress imaging are useful clinical tools for the objective assessment of anterior cruciate ligament (ACL) integrity. They are most frequently used for the diagnosis of a complete ACL tear when other workup is equivocal, in conjunction with history and clinical exam findings. Other applications include the diagnosis of partial ACL tears, injury prognosis, and post-operative monitoring. However, further studies are needed to validate these uses. Many different devices and techniques exist for objective examination, which have been compared in recent literature. Reliability and validity measures of these methods vary, and often depend upon examiner familiarity and skill. The KT series of devices is the current gold standard for arthrometry, although the newer robotic GNRB device shows promising early results. Newer methods of data interpretation have been developed for stress imaging, and portable technology may impact this field further.
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Affiliation(s)
- Eric M Rohman
- Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Ave. S, Suite R200, Minneapolis, MN, 55454, USA
| | - Jeffrey A Macalena
- Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Ave. S, Suite R200, Minneapolis, MN, 55454, USA.
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Taylor JB, Wang HM, Schmitz RJ, Rhea CK, Ross SE, Shultz SJ. Multiplanar Knee Laxity and Perceived Function During Activities of Daily Living and Sport. J Athl Train 2015; 50:1199-206. [PMID: 26540098 PMCID: PMC4732400 DOI: 10.4085/1062-6050-50.11.10] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
CONTEXT Greater knee-joint laxity may lead to a higher risk of knee injury, yet it is unknown whether results of self-reported outcome measures are associated with distinct knee-laxity profiles. OBJECTIVE To identify the extent to which multiplanar knee laxity is associated with patient-reported outcomes of knee function in healthy individuals during activities of daily living and sport. DESIGN Descriptive laboratory study. SETTING University research laboratory. PATIENTS OR OTHER PARTICIPANTS Forty healthy individuals (20 men, 20 women; age = 18-31 years). MAIN OUTCOME MEASURE(S) All participants were given the Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL) and Sports Activities Scale (KOS-SAS) and subsequently measured for knee laxity in the sagittal, frontal, and transverse planes. Separate backward stepwise regression analyses were performed to determine the extent to which multiplanar knee-laxity values predicted KOS-ADL and KOS-SAS scores within each sex. RESULTS Women had higher magnitudes of anterior, posterior (POST(LAX)), varus (VAR(LAX)), valgus (VAL(LAX)), and internal-rotation laxity than men and trended toward greater external rotation (ER(LAX)) laxity. Greater POST(LAX), less VAL(LAX), and greater VAR(LAX) was associated with lower KOS-ADL scores (KOS-ADL = -4.8 [POST(LAX)], + 3.3 [VAL(LAX)] - 2.2 [VAR(LAX)] + 100.4, R2 = 0.74, P < .001) and greater POST(LAX) and less VAL(LAX) was associated with lower KOS-SAS scores (KOS-SAS = -8.2 [POST(LAX)], + 3.6 [VAL(LAX)] + 96.4, R2 = 0.67, P < .001) in women. In men, greater POST(LAX) and less ER(LAX) was associated with lower KOS-SAS scores (KOS-ADL = -4.7 [POST(LAX)], + 0.9 [ER(LAX)] + 96.4, R2 = 0.49, P < .001). CONCLUSIONS The combination of POST(LAX) with less relative VAL(LAX) (women) or less relative ER(LAX) (men) was a strong predictor of KOS scores, suggesting that a self-reported outcome measure may be beneficial as part of a preparticipation screening battery to identify those with perceived functional deficits associated with their knee laxity.
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Affiliation(s)
| | - Hsin-Min Wang
- Department of Kinesiology, University of North Carolina at Greensboro
| | - Randy J. Schmitz
- Department of Kinesiology, University of North Carolina at Greensboro
| | | | - Scott E. Ross
- Department of Kinesiology, University of North Carolina at Greensboro
| | - Sandra J. Shultz
- Department of Kinesiology, University of North Carolina at Greensboro
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Vauhnik R, Perme MP, Barcellona MG, Morrissey MC, Sevšek F, Rugelj D. Effect of repeated passive anterior loading on human knee anterior laxity. ACTA ACUST UNITED AC 2015; 20:709-14. [DOI: 10.1016/j.math.2015.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 02/02/2015] [Accepted: 02/20/2015] [Indexed: 11/26/2022]
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Diagnostic value of the GNRB ® in relation to pressure load for complete ACL tears: A prospective case-control study of 118 subjects. Orthop Traumatol Surg Res 2015; 101:297-300. [PMID: 25813557 DOI: 10.1016/j.otsr.2015.01.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 12/27/2014] [Accepted: 01/05/2015] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The GNRB(®) is a reliable, validated arthrometer. A pressure pad exerts 0 to 250 Newtons of pressure on the upper calf. The goal of this study was to compare the diagnostic value of the different pressure loads that are usually applied for the diagnosis of complete anterior cruciate ligament (ACL) tears. Our hypothesis was that a load of 200N would be sufficient to diagnose these tears. PATIENTS AND METHODS A prospective comparative case-control study was performed in 2012. One group included all the male athletes aged 15 to 21 who presented with a complete ACL tear confirmed by arthroscopy (the study group). The control group included male soccer players in a training center aged 15 to 19 with no history of knee injuries (the control group). Anterior laxity was measured in both knees by the same experienced operator using the GNRB(®) system. The main judgment criteria were the diagnostic values of each pressure load evaluated by the area under the curve (AUC), from "Null" (AUC < 0.5) to "Perfect" (AUC = 1). RESULTS This study included 118 men: 64 in the study group, mean age 18.1 ± 2.3-years-old, who were mainly soccer players (39/64) or rugby men (16/64) and 54 control subjects, mean age 17.3 ± 1.5-years-old. Three hyperalgesic patients could not receive a pressure load of 250N. The mean differential laxity was significantly higher in the control group, whatever the pressure load (P < 10(-5)). The test was "highly informative" for all loads (0.9 ≤ AUC < 1). Analysis of the AUC revealed a diagnostic value in descending order of: 200N(0.97[0.94-1]) > 134N(0.97[0.93-0.99]) > 250N(0.96[0.93-0.99]) > 89N(0.95[0.90-0.99]). CONCLUSION The GNRB(®) at 200N was shown to be sufficient to diagnose complete ACL tears. Applying a pressure load of 250N does not appear to be useful.
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Bouguennec N, Odri GA, Graveleau N, Colombet P. Comparative reproducibility of TELOS™ and GNRB® for instrumental measurement of anterior tibial translation in normal knees. Orthop Traumatol Surg Res 2015; 101:301-5. [PMID: 25755065 DOI: 10.1016/j.otsr.2015.01.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 12/29/2014] [Accepted: 01/05/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND TELOS™ is among the reference tools for the instrumental measurement of anterior tibial translation during the initial work-up and follow-up of patients with injuries to the anterior cruciate ligament (ACL). GRNB(®) is a non-irradiating but recently developed tool for which only limited data are available. HYPOTHESIS The GRNB(®) offers better reproducibility than TELOS™ for measuring anterior tibial translation without rotation in normal knees. MATERIAL AND METHODS We retrospectively evaluated instrumental laxity measurements in normal knees. Data were available for 60 TELOS™ measurements (9kg load) and 57 GNRB(®) measurements (89N and 134N loads). For each instrument, we compared the absolute variation in anterior tibial translation between two measurements performed 6 months apart. For each GNRB(®) measurement, patellar pressure was recorded. RESULTS No significant differences were found between mean (± SD) variations in translation between the two instruments. A greater than 2.5mm variation between the two measurements was significantly more common with TELOS™ than with GRNB(®) (P<0.05, Chi(2) test). GRNB(®) translation values did not correlate with patellar pressure. DISCUSSION The GNRB(®) device offers greater reproducibility than TELOS™ when used to quantitate anterior tibial translation. The limited sample size may have prevented the detection of a significant difference between mean values. In addition, disadvantages of the TELOS™ include radiation exposure of the patient, operator-dependency of measurements made on the radiographs, and absence of a biofeedback system to limit hamstring contraction. GNRB(®) does have hamstring contraction biofeedback control but uses another parameter, namely, patellar pressure, for which the optimal value is unknown. Quadriceps and hamstring co-contraction induced by excessive patellar pressure may influence anterior tibial translation. The optimal patellar pressure value needs to be determined.
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Affiliation(s)
- N Bouguennec
- Clinique chirurgicale traumatologique et orthopédique, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
| | - G A Odri
- Service de chirurgie orthopédique, CHR Orléans, 1, rue Porte-Madeleine, 45000 Orléans, France
| | - N Graveleau
- Clinique du sport de Bordeaux-Mérignac, 9, rue Jean-Moulin, 33700 Mérignac, France
| | - P Colombet
- Clinique du sport de Bordeaux-Mérignac, 9, rue Jean-Moulin, 33700 Mérignac, France
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12
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Combined anterior and rotational laxity measurements allow characterizing personal knee laxity profiles in healthy individuals. Knee Surg Sports Traumatol Arthrosc 2015; 23:3571-7. [PMID: 25155050 PMCID: PMC4661198 DOI: 10.1007/s00167-014-3244-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 08/13/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim of this study was to quantify sagittal and rotational knee laxity profiles taking into account individual influencing factors. METHODS Linear regression models were used to determine which individual characteristics (age, height, body mass and sex) influenced the outcome in a group of 104 healthy subjects. The standardized residuals were used as individualized (corrected) laxity scores and were combined to determine knee laxity profiles. RESULTS Anterior knee laxity was not influenced by individual characteristics. Rotational knee laxity was higher in females and inversely related to body mass. The correlation between anterior laxity and internal rotation scores was weak (r = 0.24, p = 0.02). The proportion of knees concerned by increased laxity scores (scores >1) was similar for anterior displacement, internal and external rotation (15 %). Only 32 % of the tested subjects showed a normal profile (score >-1 and <1) for all three directions, 33 % were concerned by hyperlaxity, 40 % by hypolaxity and 5 % by both. CONCLUSIONS The diversity of laxity profiles found here highlights that the interpretation of multidirectional knee laxity is complex and suggests the necessity for individualized care of knee diseases and injuries. These results contribute to the understanding of knee laxity and throw the basis for prevention strategies and improvement of treatment outcomes in injuries and diseases. LEVEL OF EVIDENCE Case series with no comparison groups, Level IV.
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Vauhnik R, Morrissey MC, Perme MP, Sevsek F, Rugelj D. Inter-rater reliability of the GNRB® knee arthrometer. Knee 2014; 21:541-3. [PMID: 24239304 DOI: 10.1016/j.knee.2013.10.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 08/12/2013] [Accepted: 10/17/2013] [Indexed: 02/02/2023]
Abstract
BACKGROUND In clinical settings, where arthrometers are mainly used by different clinicians, knowing the inter-rater reliability of the instrument is crucial in order for the results from different examiners to be accurately interpreted and limitations fully understood. The aim of this study was to evaluate the inter-rater reliability of the GNRB® knee arthrometer. METHODS Knee anterior laxity in both knees was tested in a group of young, uninjured subjects (N=27, 13 females) by two examiners. Knee anterior laxity was calculated at test forces of 134 N and 250 N with values presented for the unstandardised and standardised conditions (relative to patellar stabilisation force). RESULTS The ICCs ranged from 0.220 to 0.424. CONCLUSIONS The inter-rater reliability of the GNRB® knee arthrometer is low.
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Affiliation(s)
- Renata Vauhnik
- University of Ljubljana, Faculty of Health Sciences, Department of Physiotherapy, Zdravstvena pot 5, 1000 Ljubljana, Slovenia; Arthron, Institute for Joint and Sports Injuries, Slovenia.
| | | | - Maja Pohar Perme
- University of Ljubljana, Medical Faculty, Institute for Biostatistics and Medical Informatics, Slovenia
| | - France Sevsek
- University of Ljubljana, Faculty of Health Sciences, Slovenia
| | - Darja Rugelj
- University of Ljubljana, Faculty of Health Sciences, Biomechanics Laboratory, Slovenia
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