Inter- and intratester comparison of the Rolimeter knee tester: effect of tester's experience and the examination technique

Abstract

Clinical knee examination is imperative for the prognosis, follow-up, and scientific comparison of anterior cruciate ligament surgery results. A new device, the Rolimeter knee tester was studied in this study with respect to inter- and intratester reliability. We found no significant difference in the intratester evaluation, and data were reliable between repeated measurements and between different testers with the same examination technique. The tester's experience seems to play a role using use the Rolimeter knee tester, but even an inexperienced tester can use it and obtain data that are very close to the data obtained by an experienced tester when the same technique is used. Furthermore, it was found that the manual examination of anterior translation also provides a reliable measurement, at least in the hand of experienced testers. Further advantages are that the Rolimeter knee tester is cheap, can be sterilized, and is simple to use.

An investigation to examine the inter-tester and intra-tester reliability of the Rolimeter® knee tester, and its sensitivity in identifying knee joint laxity

“…In conclusion, it can be seen from the findings of this study, and those of Muellner et al [13], that the rolimeter is a device which demonstrates both good intra-tester and inter-tester reliability in measuring anterior drawer in the knee at both 30" and 90" of flexion. It also appears that the level of experience of the rolimeter user has no significant effect on either the intra-tester or inter-tester reliability of the device.…”

“…Previous studies on the rolimeter [2,8,13] have all used a mean of repeated recordings (usually of three attempts). This is meant to allow for some variation in the techniques used, as the rolimeter requires a manual force to cause the anterior tibial translation, and it is difficult to accurately maintain this force.…”

“…It is believed that its simplicity lends it several advantages over its counterparts. It is smaller, lighter, cheaper, more compact and easy to sterilise [13]. The other leading arthrometers have been in clinical use for over 15 years and have been thoroughly investigated for reliability and sensitivity; the rolimeter has a limited reputation and has not been fully investigated.…”

“…For each examination a rolimeter reading was taken randomly from each of the 30 subjects three times consecutively at 30" knee flexion (Lachman's test) and three times consecutively at 90" knee flexion (anterior drawer) for either knee [2,8,13] (see Figs. 1 and 2).…”

Anterior cruciate ligament assessment using arthrometry and stress imaging

“…Hatcher et al found interrater reliability of 0.91-0.95 by a range of skill levels [56]. Muellner found reliability of 0.71-0.90 in experienced testers, but worse in novices [57]. Papandreou found varying interrater reliability of 0.55-0.96, which they attributed to the inherent subjectivity of the testing method [58].…”