In vitro analysis of varus-valgus laxity of the knee joint: Comparison of clinical evaluation with measurements using a reference motion analysis system |
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Authors: | R. Testa J. Chouteau R. Philippot L. Cheze M. Fessy B. Moyen |
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Affiliation: | 1. Université de Lyon, 69622, Lyon, France;2. LBMC, INRETS, UMR_T9406, 69625, Bron, France;3. Université Lyon-1, 69100 Villeurbanne, France;4. Service de chirurgie orthopédique, centre hospitalier Lyon-Sud, hospices civils de Lyon, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France;5. Laboratoire de physiologie de l’exercice, EA 4338, Saint-Étienne, France;6. Service de chirurgie orthopédique, CHU de Saint-Étienne, Saint-Étienne, 42055 cedex 2, France |
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Abstract: | IntroductionNumerous measurement devices can help clinicians during the knee examination. However, manual evaluation still remains routinely used to assess the knee laxities. The present study evaluated how accurate was a clinician for a varus-valgus stress test. We compared the clinician evaluation to the objective measurement of the knee movements during the same test session.MethodsWe studied six fresh-frozen anatomical lower limbs. The clinician performed a varus-valgus stress test in extension and at 25° flexion. The limbs were equipped with intracortical pins in femur and tibia, and spherical retro-reflecting markers were glued on the pins. Objective knees movements were measured by means of a Motion Analysis® system (Motion Analysis Corporation, Santa Rosa, CA, USA). Two statistical analyses were performed. A single sample t-test was first used to verify the required 25? flexion. Then, a multivariate anova was performed to analyse the varus-valgus laxity under the fixed factors of measurement method and flexion of the knee.ResultsThe results for varus-valgus and total laxity of the clinician always exhibited a greater variability than objective measurements of the device. Test condition is a factor of grouping differences for Valgus and for global mediolateral laxity. Statistical analysis revealed that the objective measurement was able to show a difference between extension and 25° flexion for global mediolateral laxity, whereas the clinician was not.DiscussionThe clinician was relatively accurate in his manual evaluation. However, we demonstrated that a measurement device could clearly help clinician to exhibit differences in laxity. This can be very useful to compare a knee to itself in two successive conditions, e.g., before and after a surgery. |
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