Sensitivity, repeatability and reproducibility study with a leg prototype of a recently developed knee arthrometer: The DYNEELAX®

Cojean, Théo; Batailler, Cécile; Robert, H.; Chèze, Laurence

doi:10.1016/j.medntd.2023.100254

Cited by 3 publications

(9 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Any observed deviation equal to or greater than the calculated MDCs, in any of the clinimetrics, should be considered as a substantial difference. As previously noted [ 14 , 17 ], some sources of error could be variations in patient positioning, reflex muscle contraction, and ankle tightening, which are hard to control as there is no objective manner to measure these variables.…”

Section: Discussionmentioning

confidence: 99%

“…Cojean et al [ 17 ] were the only authors who examined the DYNEELAX® reliability, although, using a prosthetic leg, which may not replicate laxity found in a living human. Nevertheless, their study reported excellent reliability results for the DYNEELAX®, which matches our findings with real knees.…”

Section: Discussionmentioning

confidence: 99%

“…Translation curves are analyzed for primary compliance (PCa) and secondary compliance (SCa), calculated between 30 N and 70 N, and from 100 N up to the maximum force applied (final point), respectively. Conversely, for internal and external rotations, a singular compliance value is computed within the range of 2 Nm to the maximum torque applied (final point) [ 17 ]. In addition here we report the anterior translation (in mm) at 150 N. Figure 1 represents the DYNEELAX® setup.…”

Section: Methodsmentioning

confidence: 99%

“…While the amount of posteriorly directed stabilizing force on the patella and ankle has been proven to directly affect the laximetry results [ 6 , 14 , 17 ], with higher forces resulting in more reliable tests, most of the existing literature on GNRB® used the manufacturer's knee tightening recommendations of a minimum of 30–50 N [ 5 , 6 , 16 – 22 ]. To date, there is no consensus on the minimum acceptable knee tightening required for a reliable measurement and there is no objective way to measure ankle tightening, since it is completely dependent on tester's feel and experience [ 17 ]. An unpublished pilot investigation in our facility suggests that knee laxity results are higher with knee tightening values inferior to approximately 75 N, after which they appear to stabilize, with the most reliable measurements being achieved from 90 N ± 5 N.…”

Section: Introductionmentioning

confidence: 99%

“…Results are plotted with translations and rotation curves, which allow for ACL and peripheral structures' compliance to be examined via the displayed force-displacement curves [ 20 , 23 ]. To our knowledge, only one reliability study has been conducted on this device [ 17 ]; however, this study used a prosthetic leg as a model.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

DYNEELAX Robotic Arthrometer Reliability and Feasibility on Healthy and Anterior Cruciate Ligament Injured/Reconstructed Persons

Nascimento,

Kotsifaki,

Papakostas

et al. 2024

Translational Sports Medicine

View full text Add to dashboard Cite

Background. Anterior cruciate ligament (ACL) injuries are commonly assessed using clinical examination and magnetic resonance imaging, but these methods have limitations in reproducibility and quantification. Instrumented laxity measurements using devices, like the DYNEELAX®, offer an alternative approach. However, to date, there is no human data on the DYNEELAX® and the reliability of these devices remains a subject of debate, and there is no consensus on appropriate knee tightening levels for testing. We hypothesized that the DYNEELAX®, with standardized knee tightening, would provide reliable measurements of knee laxity in adult volunteers. Methods. This prospective cohort study involved 48 pain-free adult volunteers. Laxity measurements were taken using a robotic-type motorized instrument (DYNEELAX®) on two separate occasions, at least 1 h and no more than 8 h apart, with knee tightening forces of 90 N ± 5 N. Metrics of anterior tibial translation and internal/external tibial axial rotations were recorded. Results. The device displayed excellent intrarater reliability for all the metrics, with intraclass correlation coefficients ranging from 0.91 to 0.96. Anterior translation exhibited the highest reliability (intraclass correlation coefficient = 0.96), with a minimum detectable change of 0.83 mm. Conclusions. DYNEELAX® is reliable in measuring knee laxity in adult volunteers when using standardized stabilizing knee tightening forces of 90 ± 5 N. The most sensitive measurement parameters (in terms of minimum detectable change as a proportion of the observed range) were anterior translation (in mm) at 150 N and secondary compliance.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

DYNEELAX Robotic Arthrometer Reliability and Feasibility on Healthy and Anterior Cruciate Ligament Injured/Reconstructed Persons

Nascimento,

Kotsifaki,

Papakostas

et al. 2024

Translational Sports Medicine

View full text Add to dashboard Cite

show abstract

All the menisco‐ligamentary structures of the medial plane play a significant role in controlling anterior tibial translation and tibial rotation of the knee. Cadaveric study of 29 knees with the Dyneelax® laximeter

Guegan,

Drouineau,

Common

et al. 2024

J. exp. orthop.

Self Cite

View full text Add to dashboard Cite

PurposeThis study aimed to determine the respective roles of the anterior cruciate ligament (ACL) and the different components of the medial plane in the control of anterior tibial translation and internal and external tibial rotation.MethodsTwenty‐nine fresh lower limbs, disarticulated at the hip, were tested in the anatomy laboratory. The following structures were isolated: the ACL, the anteromedial retinaculum (AMR), the medial collateral ligament (superficial and deep MCL), the posterior medial capsule (PMC) and the posterior horn of the medial meniscus (PHMM). The lower limb was positioned at 30° of flexion on the Dyneelax® laximeter (0.1 mm and 0.1° accuracies) and underwent anterior loads up to 200 N and internal and external tibial rotations sectioned from front to back. and the knee was then retested. The results were presented as relative gains in translation and rotations for each structure. Student's t test and Wilcoxon tests were used.ResultsThe relative gains in translation for the ACL, AMR, superficial MCL, deep MCL, PMC and PHMM, respectively, were 42.9%, 6.7%, 7.4%, 6%, 7.5% and 11.6%. The relative gains in internal rotation for ACL, AMR, superficial MCL, deep MCL, PMC and PHMM, respectively, were 13%, 6.9%, 4.6%, 3.9%, 13% and 8%. The relative gains in external rotation for ACL, AMR, superficial MCL, deep MCL, PMC and medial meniscus, respectively, were 8.9%, 6%, 9.7%, 13.8%,11.2% and 8.5%. All the relative gains in translation, internal and external rotations were significant at each step of transection (p < 0.01).ConclusionsThe ligamentous structures of the medial plane constitute a functional unit in which each component has a specific passive contribution. This study highlights the importance of recognising the extent of the medial ligament tears and performing a medial side anatomic and individual reconstruction and a suture of a ramp lesion, in addition to an ACL surgery.

show abstract

Intra‐rater and inter‐rater reliability of robotic arthrometer DYNEELAX®

Mihalinec,

Martinez‐Cepa,

Zuil‐Escobar

et al. 2024

J. exp. orthop.

View full text Add to dashboard Cite

PurposeThe purpose of our study was to test the intra‐rater and inter‐rater reliability of the DYNEELAX® arthrometer in healthy subjects. Since rotational laxity will be measured for the first time in humans, indications for normative values will also be presented.MethodsKnee anterior laxity and rotational laxity using a DYNEELAX® arthrometer were assessed in 73 subjects (39 females and 34 males). An intraclass correlation coefficient was calculated to evaluate the intra‐rater and inter‐rater reliability of the DYNEELAX®.ResultsAn intraclass correlation coefficient for intra‐rater reliability ranges from 0.631 (95% confidence interval; [CI]: 0.47–0.75) to 0.699 (95% CI: 0.56–0.80) and from 0.916 (95% CI: 0.87–0.95) to 0.94 (95% CI: 0.91–0.96) for anterior knee laxity and rotational knee laxity, respectively. An intraclass correlation coefficient for inter‐rater reliability ranges from 0.578 (95% CI: 0.40–0.71) to 0.646 (95% CI: 0.44–0.78) and from 0.822 (95% CI: 0.57–0.91) to 0.933 (95% CI: 0.89–0.96) for anterior knee laxity and rotational knee laxity, respectively.ConclusionsThe DYNEELAX® arthrometer has good to excellent intra‐rater and inter‐rater reliability for rotational knee laxity and moderate intra‐rater reliability for anterior knee laxity in healthy subjects. Future studies should investigate the clinical significance of anterior and rotational laxity measured with the DYNEELAX® arthrometer in patients with knee pathology, as both laxities are critical for assessing the integrity of the intra‐articular structures of the knee in clinical practice.Level of evidenceLevel IV.

show abstract

Sensitivity, repeatability and reproducibility study with a leg prototype of a recently developed knee arthrometer: The DYNEELAX®

Cited by 3 publications

References 48 publications

DYNEELAX Robotic Arthrometer Reliability and Feasibility on Healthy and Anterior Cruciate Ligament Injured/Reconstructed Persons

DYNEELAX Robotic Arthrometer Reliability and Feasibility on Healthy and Anterior Cruciate Ligament Injured/Reconstructed Persons

All the menisco‐ligamentary structures of the medial plane play a significant role in controlling anterior tibial translation and tibial rotation of the knee. Cadaveric study of 29 knees with the Dyneelax® laximeter

Intra‐rater and inter‐rater reliability of robotic arthrometer DYNEELAX®

Contact Info

Product

Resources

About