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Anterior knee translation measurements after ACL reconstruction are influenced by the type of laximeter used

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Sydney Orthopaedic Research Institute, Level 1, The Gallery, 445 Victoria Ave, Chatswood, NSW, 2067, Australia

    Antonio Klasan, Sven Edward Putnis, Vikram Kandhari, Takeshi Oshima & David Anthony Parker

Authors
  1. Antonio Klasan
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  2. Sven Edward Putnis
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  3. Vikram Kandhari
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  4. Takeshi Oshima
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  5. David Anthony Parker
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Contributions

AK and SP conceptualized the study, AK, SP, VK and TO gathered the data. AK analysed the data. AK and DP interpreted the data. AK and SP drafted the manuscript, VK, TO and DP revised it. All authors have given approval for the final version of the manuscript. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Antonio Klasan.

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Conflict of interest

David Parker is has been paid for presentations by Arthrex and Smith and Nephew. He is a consultant of Arthrex and Global. He holds stocks in 360 Knee Systems and Trium. All other authors have no conflicts to declare.

Ethical approval

Ethical approval for the prospective data collection was obtained from the North Sydney Local Health District (HREC/17/HAWKE/140).

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The research has been performed at the Sydney Orthopaedic Research Institute.

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Klasan, A., Putnis, S.E., Kandhari, V. et al. Anterior knee translation measurements after ACL reconstruction are influenced by the type of laximeter used. Knee Surg Sports Traumatol Arthrosc 28, 3639–3646 (2020). https://doi.org/10.1007/s00167-020-05950-5

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