Indian Journal of Physiotherapy & Occupational Therapy-An International Journal

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Comparative Analysis of Knee-laxity Measurements by a Lefthand- and a Right-hand-dominant Physiotherapist in Patients with Anterior Cruciates Ligament Injuries and Healthy Control Group


Affiliations
1 Dept. of Orthopaedics, Subharti Medical College, India
2 Subharti Physiotherapy College, Meerut, India
     

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The purpose of the study was to analyze and compare KT-1000 knee laxity as examined by a left-hand- and a righthand- dominant physiotherapist in a group of patients with an anterior cruciate ligament (ACL) injury and a group of patients, 2 years after ACL reconstruction. 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. In the ACL-deficient group, 14 patients had a right-sided ACL injury and 08 patients a left-sided ACL injury. The corresponding figures in the post-operative group were 13 patients with a right-sided ACL injury and 07 patients with a left-sided ACL injury. 20 healthy persons without any known knee problems served as controls. One left-hand- and one right-hand-dominant experienced physiotherapist performed all the examinations. The lefthand- dominant physiotherapist measured significantly higher absolute laxity values in the left knee, both injured and non-injured ones, compared with the right-handdominant 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 righthand- 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.

Keywords

ACL Injury - Knee Laxity Measurement - Left-/right- Hand Dominance of Physiotherapist
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  • 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

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

  • 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

  • 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

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

  • 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

  • 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

  • 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

  • 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

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

  • 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

  • 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

  • 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

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

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

  • 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

  • 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

  • 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

  • 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

  • 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

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

  • 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

  • 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

  • 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]

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

  • 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

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

  • 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

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

  • 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

  • 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

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

  • 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

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

  • 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

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

  • 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

  • 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


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  • Comparative Analysis of Knee-laxity Measurements by a Lefthand- and a Right-hand-dominant Physiotherapist in Patients with Anterior Cruciates Ligament Injuries and Healthy Control Group

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Authors

Vikas Trivedi
Dept. of Orthopaedics, Subharti Medical College, India
Vaibhav Agarwal
Subharti Physiotherapy College, Meerut, India

Abstract


The purpose of the study was to analyze and compare KT-1000 knee laxity as examined by a left-hand- and a righthand- dominant physiotherapist in a group of patients with an anterior cruciate ligament (ACL) injury and a group of patients, 2 years after ACL reconstruction. 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. In the ACL-deficient group, 14 patients had a right-sided ACL injury and 08 patients a left-sided ACL injury. The corresponding figures in the post-operative group were 13 patients with a right-sided ACL injury and 07 patients with a left-sided ACL injury. 20 healthy persons without any known knee problems served as controls. One left-hand- and one right-hand-dominant experienced physiotherapist performed all the examinations. The lefthand- dominant physiotherapist measured significantly higher absolute laxity values in the left knee, both injured and non-injured ones, compared with the right-handdominant 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 righthand- 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.

Keywords


ACL Injury - Knee Laxity Measurement - Left-/right- Hand Dominance of Physiotherapist

References