Anterior Subluxation in Knees with Chronic Anterior Cruciate Ligament Insufficiency: A Comparison of Arthrometry and Stressradiography

Abstract

It is generally acknowledged that the severity of a knee injury can be assessed by the clinical testing of knee stability. Although a number of objective test procedures have been devised (Kennedy and Fowler 1971; Markolf et al. 1978; Jacobsen 1981; Stedtfeld and Strobel 1988; Shino et al. 1984; Daniel et al. 1985; Edixhoven 1986; Edixhoven et al. 1987; Kärrholm et al. 1988), the diagnosis of a knee instability is based largely on the systematic evaluation of the primary and secondary restraints of the knee joint. Although some instability tests are widely used, there are significant examiner-dependent variations in terms of the starting position for varus-valgus testing and the resting position prior to anteroposterior drawer testing. Systematic preoperative stability testing of the cruciate and collateral ligaments can be hampered by various factors such as pain, effusion, and muscle spasm. Thus, systematic instability testing under anesthesia, as recommended by the Swiss OAK knee group (Milller et al. 1988), is preferred over clinical testing without anesthesia for the documentation of comparable, reproducible physical findings.