Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

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


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

   Subscribe/Renew Journal


The purpose of the study was to analyze 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 analyze knee laxity in a group of persons without any known knee problems. A crosssectional examination of two groups of patients preoperatively and post-operatively after ACL reconstruction and examination of healthy controls on two different occasions was performed. 22 patients who were scheduled for ACL reconstruction and 20 patients who attended a 2- year follow-up examination were included in the study. 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. 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-handdominant physiotherapist. Correspondingly, the left-handdominant 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
Subscription Login to verify subscription
User
Notifications
Font Size


  • 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 testingfor 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 interrater 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 followup 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 SportsMed 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 RP (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

Abstract Views: 380

PDF Views: 0




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

Abstract Views: 380  |  PDF Views: 0

Authors

Vikas Trivedi
Dept. of Orthopaedics, Subharti Medical College, Meerut, India
Vaibhav Agarwal
Subharti Physiotherapy College, Meerut, India
Neha Sharma
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 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 analyze knee laxity in a group of persons without any known knee problems. A crosssectional examination of two groups of patients preoperatively and post-operatively after ACL reconstruction and examination of healthy controls on two different occasions was performed. 22 patients who were scheduled for ACL reconstruction and 20 patients who attended a 2- year follow-up examination were included in the study. 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. 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-handdominant physiotherapist. Correspondingly, the left-handdominant 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