Knee-laxity measurements examined by a left-hand- and a right-hand-dominant physiotherapist, in patients with anterior cruciate ligament injuries and healthy controls

Abstract

The purpose of the study was to analyse 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 analyse knee laxity in a group of persons without any known knee problems. 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. Fifty-three patients who were scheduled for ACL reconstruction and 39 patients who attended a 2-year follow-up examination were included in the study. In the ACL-deficient group, 32 patients had a right-sided ACL injury and 21 patients a left-sided ACL injury. The corresponding figures in the post-operative group were 21 patients with a right-sided ACL injury and 18 patients with a left-sided ACL injury. Twenty-eight 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-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. Level of evidence is II.

Anterior cruciate ligament assessment using arthrometry and stress imaging

“…The few other published reliability measures vary, with intra-rater reliability ranging from 0.67 to 0.99 and inter-rater reliability ranging from 0.65 to 0.92 [37,40,44]. Many factors influence test reliability, including examiner experience, device overtightening, improper positioning, inconsistent force application, leg external/internal rotation, examiner hand dominance, and knee effusions [34,39,40,[44][45][46][47][48][49]. Although only explicitly studied with the KT system, several of these factors could conceivably affect other devices as well.…”

Objective measurements of static anterior and rotational knee laxity

“…Its reproducibility was however questioned as examiner experience [6] and hand dominance [7] have been reported to influence its measurements. The interrater error was estimated at 2.9 mm for experienced examiners [8].…”

Reproductibilité comparée du TELOS™ et du GNRB® sur genou sain pour la mesure instrumentale de la translation antérieure du tibia

“…Une limite de cette étude était le faible nombre des effectifs qui a pu méconnaître une différence significative des moyennes même si celles-ci correspondent aux données de la littérature évaluant un système de laximétrie [15][16][17][18]. Les paramètres de comparaison des populations correspondent à ceux de la littérature [13] et les séries étaient statistiquement comparables.…”