scholarly journals Nonweight-bearing anterior knee laxity is related to anterior tibial translation during transition from nonweight bearing to weight bearing

2006 ◽  
Vol 24 (3) ◽  
pp. 516-523 ◽  
Author(s):  
Sandra J. Shultz ◽  
Yohei Shimokochi ◽  
Anh-Dung Nguyen ◽  
Jatin P. Ambegaonkar ◽  
Randy J. Schmitz ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Knee Laxity ◽  
Anterior Tibial Translation ◽  
Anterior Knee Laxity ◽  
Anterior Tibial ◽  
Tibial Translation ◽  
Anterior Knee

The Relationship between Grading and Instrumented Measurements of Anterior Knee Joint Laxity

2008 ◽  
Vol 17 (1) ◽  
pp. 60-67 ◽  
Author(s):  
Wendy L. Hurley ◽  
Craig Denegar ◽  
William E. Buckley
Keyword(s):  
Athletic Trainers ◽  
Knee Laxity ◽  
Anterior Tibial Translation ◽  
Clinical Judgments ◽  
Certified Athletic Trainers ◽  
Anterior Knee Laxity ◽  
Anterior Tibial ◽  
Tibial Translation ◽  
The Relationship ◽  
Anterior Knee

Context:The relationship between clinical judgments of anterior knee laxity and instrumented measurement of anterior tibial translation is unclear.Objective:To examine the relationship between certified athletic trainers’ grading of anterior knee laxity and instrumented measurements of anterior tibial translation.Design:Randomized, blinded, clinical assessment.Setting:Laboratory.Participants:Model patients receiving evaluation of anterior knee laxity.Intervention:Twelve model patients were evaluated using a MEDmetric® KT1000™ knee ligament Arthrometer® to establish instrumented measurements of anterior translation values at the tibio-femoral joint. Twenty-two certified athletic trainers were provided with operational definitions of potential laxity grades and examined the model patients to make judgments of anterior knee laxity.Main Outcome Measures:Correlation between clinical judgments and instrumented measurements of anterior tibial translation.Results:Clinical judgments and instrumented measurements were mutually independent.Conclusions:Anterior tibial translation grading by certified athletic trainers should be interpreted with caution during clinical decision-making.

Arthroscopic Fixation of Anterior Tibial Spine Fractures with Bioabsorbable Nails in Skeletally Immature Patients

2009 ◽  
Vol 37 (5) ◽  
pp. 923-928 ◽  
Author(s):  
Kristin Liljeros ◽  
Suzanne Werner ◽  
Per-Mats Janarv
Keyword(s):  
Knee Laxity ◽  
Activity Level ◽  
Spine Fractures ◽  
Tibial Spine ◽  
Hop Tests ◽  
Metallic Implants ◽  
Anterior Knee Laxity ◽  
Anterior Tibial ◽  
Arthroscopic Fixation ◽  
Anterior Knee

Background A number of arthroscopic techniques have been introduced in the treatment of displaced anterior tibial spine fractures. Several of the procedures are technically demanding or include a second removal operation of metallic implants. Purpose The purpose of this study is to describe and evaluate an arthroscopic technique using bioabsorbable nails in displaced anterior tibial spine fractures. Study Design Case series; Level of evidence, 4. Methods Sixteen consecutive patients, aged 7 to 15 years, with anterior tibial spine fractures type II and III according to Meyers and McKeever, were treated with arthroscopic fixation of the fragment using bioabsorbable nails. After 2 to 5 years, 13 of the patients were evaluated with regard to anterior knee laxity, range of motion, hop tests, Lysholm knee scoring scale, and activity level. Postoperative surgical complications were registered in the whole group of patients. Results One of the 13 patients had an increased anterior knee laxity of 3 mm. Extension deficits of 5° were seen in 4 patients and flexion deficits of 5° to 10° in 3 patients. One patient had an outcome of <90% of the uninjured side in the hop tests. Eleven patients were excellent, 1 was good, and 1 was poor according to the Lysholm knee scoring scale. There was no influence on activity level. There were no inflammatory reactions and all fractures healed without complications. In 1 case, the arthroscopy was converted into an open procedure because of technical problems, still using the bioabsorbable nails. Conclusion The outcome is comparable with other procedures. A second operation for removal of metallic implants is avoided.

scholarly journals Knee laxity and functional knee outcome after contralateral ACLR are comparable to those after primary ACLR

2021 ◽  
Author(s):  
Riccardo Cristiani ◽  
Sofia Viheriävaara ◽  
Per-Mats Janarv ◽  
Gunnar Edman ◽  
Magnus Forssblad ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Anterior Tibial Translation ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Anterior Tibial ◽  
The Mean ◽  
Tibial Translation

Abstract Purpose To evaluate and compare knee laxity and functional knee outcome between primary and contralateral anterior cruciate ligament (ACL) reconstruction. Methods Patients who underwent primary and subsequent contralateral ACL reconstruction (ACLR) at Capio Artro Clinic, Stockholm, Sweden, from 2001 to 2017, were identified in our local database. The inclusion criteria were: the same patients who underwent primary and contralateral hamstring tendon or bone-patellar tendon-bone autograft ACLR and no associated ligament injuries. The KT-1000 arthrometer, with an anterior tibial load of 134 N, was used to evaluate knee laxity preoperatively and 6 months postoperatively. The Knee injury and Osteoarthritis Outcome Score (KOOS) was collected preoperatively and at the 1-year follow-up. Results A total of 326 patients with isolated primary and contralateral ACLR met the inclusion criteria (47.9% males; mean age at primary ACLR 23.9 ± 9.4 years and contralateral ACLR 27.9 ± 10.1 years). The arthrometric laxity measurements were available for primary and contralateral ACLR for 226 patients. The mean preoperative and postoperative anterior tibial translation (ATT), as well as the mean ATT reduction from preoperatively to postoperatively, did not differ significantly between primary and contralateral ACLR. The KOOS was available for primary and contralateral ACLR for 256 patients. No significant differences were found preoperatively and at the 1-year follow-up between primary and contralateral ACLR for any of the five KOOS subscales. Conclusion The findings in this study showed that anterior knee laxity and functional knee outcome after contralateral ACLR are comparable to those after primary ACLR. It is important for clinicians to counsel patients about their expectations after contralateral ACLR. This study shows that the results after contralateral ACLR in terms of knee laxity and functional knee outcome are predictable and likely to be comparable to those after primary ACLR. Level of evidence Level III.

Anterior Tibial Translation During Squatting with Tip Toe Weight Bearing: An Arthrometric and Eletromyographic Analysis.

2000 ◽  
Vol 49 (4) ◽  
pp. 1188-1190
Author(s):  
Takeshi Kanamiya ◽  
Michiya Hara ◽  
Keihan Cho ◽  
Kei Koga ◽  
Gen Emoto ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Anterior Tibial Translation ◽  
Anterior Tibial ◽  
Tibial Translation

scholarly journals Anterior and Rotational Knee Laxity Does Not Affect Patient-Reported Knee Function 2 Years After Anterior Cruciate Ligament Reconstruction

2019 ◽  
Vol 47 (9) ◽  
pp. 2077-2085 ◽  
Author(s):  
Robert Magnussen ◽  
Emily K. Reinke ◽  
Laura J. Huston ◽  
Jack T. Andrish ◽  
Charles L. Cox ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Anterior Tibial Translation ◽  
Patient Reported ◽  
Anterior Tibial ◽  
Kt 1000 ◽  
Tibial Translation ◽  
Rotational Knee Laxity

Background: While a primary goal of anterior cruciate ligament (ACL) reconstruction is to reduce pathologically increased anterior and rotational knee laxity, the relationship between knee laxity after ACL reconstruction and patient-reported knee function remains unclear. Hypothesis: There would be no significant correlation between the degree of residual anterior and rotational knee laxity and patient-reported outcomes (PROs) 2 years after primary ACL reconstruction. Study Design: Cross-sectional study; Level of evidence, 3. Methods: From a prospective multicenter nested cohort of patients, 433 patients younger than 36 years of age injured in sports with no history of concomitant ligament surgery, revision ACL surgery, or surgery of the contralateral knee were identified and evaluated at a minimum 2 years after primary ACL reconstruction. Each patient underwent Lachman and pivot-shift evaluation as well as a KT-1000 arthrometer assessment along with Knee injury and Osteoarthritis Outcome Score and subjective International Knee Documentation Committee (IKDC) scores. A proportional odds logistic regression model was used to predict each 2-year PRO score, controlling for preoperative score, age, sex, body mass index, smoking, Marx activity score, education, subsequent surgery, meniscal and cartilage status, graft type, and range of motion asymmetry. Measures of knee laxity were independently added to each model to determine correlation with PROs. Results: Side-to-side manual Lachman differences were IKDC A in 246 (57%) patients, IKDC B in 183 (42%) patients, and IKDC C in 4 (<1%) patients. Pivot-shift was classified as IKDC A in 209 (48%) patients, IKDC B in 183 (42%) patients, and IKDC C in 11 (2.5%) patients. The mean side-to-side KT-1000 difference was 2.0 ± 2.6 mm. No significant correlations were noted between pivot-shift or anterior tibial translation as assessed by Lachman or KT-1000 and any PRO. All predicted differences in PROs based on IKDC A versus B pivot-shift and anterior tibial translation were less than 4 points. Conclusion: Neither the presence of IKDC A versus B pivot-shift nor increased anterior tibial translation of up to 6 mm is associated with clinically relevant decreases in PROs 2 years after ACL reconstruction.

scholarly journals The evaluation of Rolimeter, KLT, KiRA and KT-1000 arthrometer in healthy individuals shows acceptable intra-rater but poor inter-rater reliability in the measurement of anterior tibial knee translation

2021 ◽  
Author(s):  
Armin Runer ◽  
Tommaso Roberti di Sarsina ◽  
Vasco Starke ◽  
Alessandra Iltchev ◽  
Gernot Felmet ◽  
...  
Keyword(s):  
False Positive ◽  
Intraclass Correlation ◽  
Test Procedure ◽  
Correlation Coefficients ◽  
Knee Laxity ◽  
Anterior Tibial Translation ◽  
Rater Reliability ◽  
Anterior Tibial ◽  
Kt 1000 ◽  
Tibial Translation

Abstract Purpose To assess measurement equivalence, inter- and intra-rater reliability, standard error of measurements (SEM) and false positive measurements (FPM) of four different knee arthrometers (KLT,Karl Storz; KiRA, I + ; KT-1000 MEDmetric Corp; Rolimeter, Aircast) in healthy patients. Methods Four different investigators (two advanced (AR) and two beginners (BR)) examined 12 participants with healthy knees at two time points with regards to anterior tibial translation (ATT) and side-to-side difference (SSD). Test equivalence was assessed using the TOST (two-one-sided t test) procedure with ± 1 mm equivalence boundaries. Intraclass correlation coefficients (ICCs) were calculated using two-way mixed effects models. Furthermore, false positive-(SSD > 3 mm) and SEMs were assessed. Results A total of 2304 Lachman Tests were performed. Between-rater SSDs were equivalent between AR and BR raters for the Rolimeter only. Inter-rater ICC values (SSD, ATT) were graded as “poor” to “moderate” for all devices. Equivalent test–retest results were observed for all raters using the Rolimeter, KLT and KT-1000, whereas measurement consistency with KiRA was given in the advanced examiners group only. Intra-rater ICC values (Range: SSD, ATT) were graded as “poor” to “moderate” for SSD values and “moderate” to “good” for ATT. SEMs were lowest for the Rolimeter and highest for KiRA. FPM were never obtained with the Rolimeter (0%), twice (2.1%) with the KT-1000, three times (3.1%) with the KLT and 33 times (34.4%) using KiRA. Conclusion There is acceptable intra-rater but poor inter-rater reliability with all tested arthrometers. Measures of knee laxity are comparable between Rolimeter, KLT and KT-1000 but higher for KiRA. Clinically, the present study shows that repeated arthrometry measurements should always be performed by the same investigators.

scholarly journals Copers and Noncopers Use Different Landing Techniques to Limit Anterior Tibial Translation After Anterior Cruciate Ligament Reconstruction

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712199806
Author(s):  
Michèle N.J. Keizer ◽  
Egbert Otten ◽  
Chantal M.I. Beijersbergen ◽  
Reinoud W. Brouwer ◽  
Juha M. Hijmans
Keyword(s):  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Anterior Tibial Translation ◽  
Return To Sports ◽  
Beighton Score ◽  
Positive Correlation ◽  
Anterior Tibial ◽  
Flexion Moment ◽  
Anterior Cruciate ◽  
Tibial Translation

Background: At 1 year after anterior cruciate ligament reconstruction (ACLR), two-thirds of patients manage to return to sports (copers), whereas one-third of patients do not return to sports (noncopers). Copers and noncopers have different muscle activation patterns, and noncopers may not be able to control dynamic anterior tibial translation (ATTd) as well as copers. Purpose/Hypothesis: To investigate whether (1) there is a positive correlation between passive ATT (ATTp; ie, general joint laxity) and ATTd during jump landing, (2) whether ATTd is moderated by muscle activating patterns, and (3) whether there is a difference in moderating ATTd between copers and noncopers. We hypothesized that patients who have undergone ACLR compensate for ATTd by developing muscle strategies that are more effective in copers compared with noncopers. Study Design: Controlled laboratory study. Methods: A total of 40 patients who underwent unilateral ACLR performed 10 single-leg hops for distance with both legs. Lower body kinematic and kinetic data were measured using a motion-capture system, and ATTd was determined with an embedded method. Muscle activity was measured using electromyographic signals. Bilateral ATTp was measured using a KT-1000 arthrometer. In addition, the Beighton score was obtained. Results: There was no significant correlation between ATTp and ATTd in copers; however, there was a positive correlation between ATTp and ATTd in the operated knee of noncopers. There was a positive correlation between the Beighton score and ATTp as well as between the Beighton score and ATTd in both copers and noncopers in the operated knee. Copers showed a negative correlation between ATTd and gastrocnemius activity in their operated leg during landing. Noncopers showed a positive correlation between ATTd and knee flexion moment in their operated knee during landing. Conclusion: Copers used increased gastrocnemius activity to reduce ATTd, whereas noncopers moderated ATTd by generating a smaller knee flexion moment. Clinical Relevance: This study showed that copers used different landing techniques than noncopers. Patients who returned to sports after ACLR had sufficient plantar flexor activation to limit ATTd.

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