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Knee-laxity measurements examined by a left-hand- and a right-hand-dominant physiotherapist, in patients with anterior cruciate ligament injuries and healthy controls

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The purpose of the study was to analyse and compare KT-1000 knee laxity as examined by a left-hand- and a right-hand-dominant physiotherapist in a group of patients with an anterior cruciate ligament (ACL) injury and a group of patients, 2 years after ACL reconstruction. The other aim was to measure and analyse knee laxity in a group of persons without any known knee problems. A cross-sectional examination of two groups of patients pre-operatively and post-operatively after ACL reconstruction and examination of healthy controls on two different occasions was performed. Fifty-three patients who were scheduled for ACL reconstruction and 39 patients who attended a 2-year follow-up examination were included in the study. In the ACL-deficient group, 32 patients had a right-sided ACL injury and 21 patients a left-sided ACL injury. The corresponding figures in the post-operative group were 21 patients with a right-sided ACL injury and 18 patients with a left-sided ACL injury. Twenty-eight healthy persons without any known knee problems served as controls. One left-hand- and one right-hand-dominant experienced physiotherapist performed all the examinations. To be able to evaluate the intra and inter-reliability of the examiners the controls were examined at two occasions. The left-hand-dominant physiotherapist measured significantly higher absolute laxity values in the left knee, both injured and non-injured ones, compared with the right-hand-dominant physiotherapist. This was found irrespectively of whether the patients belonged to the ACL deficient or the post-operative group. In the healthy control group, the right-hand-dominant physiotherapist measured significantly higher knee-laxity values in the right knee compared with the left-hand-dominant physiotherapist. Correspondingly, the left-hand-dominant physiotherapist measured significantly higher knee laxity values in the left knee. We conclude that KT-1000 arthrometer laxity measurements can be affected by the hand dominance of the examiner. This might affect the reliability of KT-1000 arthrometer measurements. Level of evidence is II.

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References

  1. Anderson AF, Snyder RB, Federspiel CF, Lipscomb AB (1992) Instrumented evaluation of knee laxity: a comparison of five arthrometers. Am J Sports Med 20:135–140

    Article  PubMed  CAS  Google Scholar 

  2. Andersson C, Gillquist J (1990) Instrumented testing for evaluation of sagittal knee laxity. Clin Orthop 256:178–184

    PubMed  Google Scholar 

  3. Bach BR Jr, Warren RF, Flynn WM, Kroll M, Wickiewiecz TL (1990) Arthrometric evaluation of knees that have a torn anterior cruciate ligament. J Bone Joint Surg [Am] 72:1299–1306

    Google Scholar 

  4. Balasch H, Schiller M, Friebel H, Hoffmann F (1999) Evaluation of anterior knee joint instability with the Rolimeter. A test in comparison with manual assessment and measuring with the KT-1000 arthrometer. Knee Surg Sports Traumatol Arthrosc 7:204–208

    Article  PubMed  CAS  Google Scholar 

  5. Ballantyne BT, French AK, Heimsoth SL, Kachingwe AF, Lee JB, Soderberg GL (1995) Influence of examiner experience and gender on interrater reliability of KT-1000 arthrometer measurements. Phys Ther 75:898–906

    PubMed  CAS  Google Scholar 

  6. Berry J, Kramer K, Binkley J, Binkley GA, Stratford P, Hunter S et al (1999) Error estimates in novice and expert raters for the KT-1000 arthrometer. J Orthop Sports Phys Ther 29:49–55

    PubMed  CAS  Google Scholar 

  7. Brosky JA Jr, Nitz AJ, Malone TR, Caborn DN, Rayens MK (1999) Intrarater reliability of selected clinical outcome measures following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 29:39–48

    PubMed  Google Scholar 

  8. Daniel DM (1993) Reference, maintenance and user´s guide for the knee ligament arthrometer. MEDmetric Corporation, 7542 Trade Street, San Diego, California, pp 92121–92412

  9. Daniel DM, Stone ML, Sachs R, Malcom L (1985) Instrumented measurement of anterior knee laxity in patients with acute anterior cruciate ligament disruption. Am J Sports Med 13:401–407

    Article  PubMed  CAS  Google Scholar 

  10. Eriksson E (1999) Objective measurement of sagittal laxity of the knee. Knee Surg Sports Traumatol Arthrosc 7:203

    Article  PubMed  CAS  Google Scholar 

  11. Feller J, Hoser C, Webster K (2000) EMG biofeedback assisted KT-1000 evaluation of anterior tibial displacement. Knee Surg Sports Traumatol Arthrosc 8:132–136

    Article  PubMed  CAS  Google Scholar 

  12. Fiebert I, Gresley J, Hoffman S, Kunkel K (1994) Comparative measurements of anterior tibial translation using the KT-1000 knee arthrometer with the leg in neutral, internal rotation, and external rotation. J Orthop Sports Phys Ther 19:331–334

    PubMed  CAS  Google Scholar 

  13. Graham GP, Johnson S, Dent CM, Fairclough JA (1991) Comparison of clinical tests and the KT-1000 in the diagnosis of anterior cruciate ligament rupture. Br J Sports Med 25:96–97

    Article  PubMed  CAS  Google Scholar 

  14. Hang YS, Fung WC, Hang D (1993) Quantitative test of knee laxity in Chinese. J Formos Med Assoc 92:907–910

    PubMed  CAS  Google Scholar 

  15. Hanten WP, Pace MB (1987) Reliability of measuring anterior laxity of the knee joint using a knee ligament arthrometer. Phys Ther 67:357–359

    PubMed  CAS  Google Scholar 

  16. Harter RA, Osternig LR, Singer KM (1989) Instrumented Lachman tests for the evaluation of anterior laxity after reconstruction of the anterior cruciate ligament. J Bone Joint Surg [Am] 71:975–983

    CAS  Google Scholar 

  17. Highgenboten CL, Jackson A, Meske NB (1989) Genucom, KT-1000, and Stryker knee laxity measuring device comparisons. Device reproducibility and interdevice comparison in asymptomatic subjects. Am J Sports Med 17:743–746

    Article  PubMed  CAS  Google Scholar 

  18. Huber FE, Irrgang JJ, Harner C, Lephart S (1997) Intratester and intertester reliability of the KT-1000 arthrometer in the assessment of posterior laxity of the knee. Am J Sports Med 25:479–485

    Article  PubMed  CAS  Google Scholar 

  19. Karageanes SJ, Blackburn K, Vangelos ZA (2000) The association of the menstrual cycle with the laxity of the anterior cruciate ligament in adolescent female athletes. Clin J Sport Med 10:162–168

    Article  PubMed  CAS  Google Scholar 

  20. Kartus J, Stener S, Köhler K, Sernert N, Eriksson BI, Karlsson J (1997) Is bracing after anterior cruciate ligament reconstruction necessary? A 2-year follow-up of 78 consecutive patients rehabilitated with or without a brace. Knee Surg Sports Traumatol Arthrosc 5:157–161

    Article  PubMed  CAS  Google Scholar 

  21. Malcom LL, Daniel DM, Stone ML, Sachs R (1985) The measurement of anterior knee laxity after ACL reconstructive surgery. Clin Orthop 196:35–41

    PubMed  Google Scholar 

  22. Mononen T, Alaranta H, Harilainen A, Sandelin J, Vanhanen I, Osterman K (1997) Instrumented measurement of anterior-posterior translation in knees with chronic anterior cruciate ligament tear. Arch Orthop Trauma Surg 116:283–286

    PubMed  CAS  Google Scholar 

  23. Myrer JW, Schulthies SS, Fellingham GW (1996) Relative and absolute reliability of the KT-2000 arthrometer for uninjured knees. Testing at 67, 89, 134, and 178 N and manual maximum forces. Am J Sports Med 24:104–108

    Article  PubMed  CAS  Google Scholar 

  24. Neuschwander DC, Drez D Jr, Paine RM, Young JC (1990) Comparison of anterior laxity measurements in anterior cruciate deficient knees with two instrumented testing devices. Orthopedics 13:299–302

    PubMed  CAS  Google Scholar 

  25. Oliver JH, Coughlin LP (1987) Objective knee evaluation using the Genucom Knee Analysis System. Clinical implications. Am J Sports Med 15:571–578

    Article  PubMed  CAS  Google Scholar 

  26. Rangger C, Daniel DM, Stone ML, Kaufman K (1993) Diagnosis of an ACL disruption with KT-1000 arthrometer measurements. Knee Surg Sports Traumatol Arthrosc 1:60–66

    Article  PubMed  CAS  Google Scholar 

  27. Riederman R, Wroble RR, Grood ES, VanGinkel L, Shaffer BL (1991) Reproducibility of the knee signature system. Am J Sports Med 19:660–664

    Article  PubMed  CAS  Google Scholar 

  28. Robnett NJ, Riddle DL, Kues JM (1995) Intertester reliability of measurements obtained with the KT-1000 on patients with reconstructed anterior cruciate ligaments. J Orthop Sports Phys Ther 21:113–119

    PubMed  CAS  Google Scholar 

  29. Rosene J, TD F (1999) Anterior tibial translation in collegiate athletes with normal anterior cruciate ligament integrity. J Athletic Training 34:93–98

    CAS  Google Scholar 

  30. Sernert N, Kartus J, Köhler K, Ejerhed L, Karlsson J (2001) Evaluation of the reproducibility of the KT-1000 arthrometer. Scand J Med Sci Sports 11:120–125

    Article  PubMed  CAS  Google Scholar 

  31. Sernert N, Kartus JT, Ejerhed L, Karlsson J (2004) Right and left knee laxity measurements: a prospective study of patients with anterior cruciate ligament injuries and normal control subjects. Arthroscopy 20:564–571

    Article  PubMed  Google Scholar 

  32. Shelbourne KD, Nitz P (1990) Accelerated rehabilitation after anterior cruciate ligament reconstruction. Am J Sports Med 18:292–299

    Article  PubMed  CAS  Google Scholar 

  33. Shino K, Inoue M, Horibe S, Nakamura H, Ono K (1987) Measurement of anterior instability of the knee. A new apparatus for clinical testing. J Bone Joint Surg [Br] 69:608–613

    CAS  Google Scholar 

  34. Skinner HB, Wyatt MP, Stone ML, Hodgdon JA, Barrack RL (1986) Exercise-related knee joint laxity. Am J Sports Med 14:30–34

    Article  PubMed  CAS  Google Scholar 

  35. Steiner ME, Brown C, Zarins B, Brownstein B, Koval PS, Stone P (1990) Measurement of anterior–posterior displacement of the knee. A comparison of the results with instrumented devices and with clinical examination. J Bone Joint Surg [Am] 72:1307–1315

    CAS  Google Scholar 

  36. Stäubli HU, Jakob RP (1991) Anterior knee motion analysis. Measurement and simultaneous radiography. Am J Sports Med 19:172–177

    Article  PubMed  Google Scholar 

  37. Torzilli PA, Panariello RA, Forbes A, Santner TJ, Warren RF (1991) Measurement reproducibility of two commercial knee test devices. J Orthop Res 9:730–737

    Article  PubMed  CAS  Google Scholar 

  38. Wojtys EM, Wylie BB, Huston LJ (1996) The effects of muscle fatigue on neuromuscular function and anterior tibial translation in healthy knees. Am J Sports Med 24:615–621

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Fyrbodal Research Institute, Norra Älvsborg County Hospital, 451 85, Trollhättan, Uddevalla, Sweden

    Ninni Sernert & Lars Ejerhed

  2. Department of Physiotherapy, Norra Älvsborg County Hospital, Trollhättan, Uddevalla, Sweden

    Ninni Sernert & Janett Helmers

  3. City Physiotherapy, Trollhättan, Sweden

    Catarina Kartus

  4. Department of Orthopaedics, Norra Älvsborg County Hospital, Trollhättan, Sweden

    Jüri Kartus

Authors
  1. Ninni Sernert
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  2. Janett Helmers
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  3. Catarina Kartus
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  4. Lars Ejerhed
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  5. Jüri Kartus
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Correspondence to Ninni Sernert.

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Sernert, N., Helmers, J., Kartus, C. et al. Knee-laxity measurements examined by a left-hand- and a right-hand-dominant physiotherapist, in patients with anterior cruciate ligament injuries and healthy controls . Knee Surg Sports Traumatol Arthr 15, 1181–1186 (2007). https://doi.org/10.1007/s00167-007-0347-3

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  • DOI: https://doi.org/10.1007/s00167-007-0347-3

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