Standardising the clinical assessment of coronal knee laxity

Jon V. Clarke, William T. Wilson, Scott C. Wearing, Frederic Picard, Philip E. Riches, Angela H. Deakin

Research output: Contribution to journalArticle

13 Citations (Scopus)
160 Downloads (Pure)

Abstract

Clinical laxity tests are used for assessing knee ligament injuries and for soft tissue balancing in total knee arthroplasty. This study reports the development and validation of a quantitative technique of assessing collateral knee laxity
through accurate measurement of potential variables during routine clinical
examination. The hypothesis was that standardisation of a clinical stress test
would result in a repeatable range of laxity measurements.Non- invasive
infrared tracking technology with kinematic registration of joint centres gave
real-time measurement of both coronal and sagittal mechanical tibiofemoral
alignment. Knee flexion, moment arm and magnitude of the applied force were all measured and standardised. Three clinicians then performed six knee laxity
examinations on a single volunteer using a target moment of 18Nm. Standardised laxity measurements had small standard deviations (within 1.1°) for each clinician and similar mean values between clinicians, with the valgus laxity
assessment (mean of 3°) being slightly more consistent than varus (means of 4°
or 5°).The manual technique of coronal knee laxity assessment was successfully
quantified and standardised, leading to a narrow range of measurements (within
the accuracy of the measurement system). Minimising the subjective variables of
clinical examination could improve current knowledge of soft tissue knee
behaviour.
Original languageEnglish
Pages (from-to)699-708
Number of pages10
JournalProceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine
Volume226
Issue number9
Early online date3 Jul 2012
DOIs
Publication statusPublished - 1 Sep 2012

Fingerprint

Knee
Knee Injuries
Knee Replacement Arthroplasties
Tissue
Arthroplasty
Ligaments
Biomechanical Phenomena
Volunteers
Time measurement
Standardization
Technology
Kinematics

Keywords

  • clinical assessment
  • knee laxity
  • ligament injuries
  • non-invasive assessment
  • total knee arthroplasty

Cite this

Clarke, Jon V. ; Wilson, William T. ; Wearing, Scott C. ; Picard, Frederic ; Riches, Philip E. ; Deakin, Angela H. / Standardising the clinical assessment of coronal knee laxity. In: Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine . 2012 ; Vol. 226, No. 9. pp. 699-708.
@article{71823450300d414bbab3290d1fc5968b,
title = "Standardising the clinical assessment of coronal knee laxity",
abstract = "Clinical laxity tests are used for assessing knee ligament injuries and for soft tissue balancing in total knee arthroplasty. This study reports the development and validation of a quantitative technique of assessing collateral knee laxitythrough accurate measurement of potential variables during routine clinicalexamination. The hypothesis was that standardisation of a clinical stress testwould result in a repeatable range of laxity measurements.Non- invasiveinfrared tracking technology with kinematic registration of joint centres gavereal-time measurement of both coronal and sagittal mechanical tibiofemoralalignment. Knee flexion, moment arm and magnitude of the applied force were all measured and standardised. Three clinicians then performed six knee laxityexaminations on a single volunteer using a target moment of 18Nm. Standardised laxity measurements had small standard deviations (within 1.1°) for each clinician and similar mean values between clinicians, with the valgus laxityassessment (mean of 3°) being slightly more consistent than varus (means of 4°or 5°).The manual technique of coronal knee laxity assessment was successfullyquantified and standardised, leading to a narrow range of measurements (withinthe accuracy of the measurement system). Minimising the subjective variables ofclinical examination could improve current knowledge of soft tissue kneebehaviour.",
keywords = "clinical assessment, knee laxity , ligament injuries, non-invasive assessment, total knee arthroplasty",
author = "Clarke, {Jon V.} and Wilson, {William T.} and Wearing, {Scott C.} and Frederic Picard and Riches, {Philip E.} and Deakin, {Angela H.}",
year = "2012",
month = "9",
day = "1",
doi = "10.1177/0954411912451814",
language = "English",
volume = "226",
pages = "699--708",
journal = "Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine",
issn = "0954-4119",
number = "9",

}

Standardising the clinical assessment of coronal knee laxity. / Clarke, Jon V.; Wilson, William T.; Wearing, Scott C.; Picard, Frederic; Riches, Philip E.; Deakin, Angela H.

In: Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine , Vol. 226, No. 9, 01.09.2012, p. 699-708.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Standardising the clinical assessment of coronal knee laxity

AU - Clarke, Jon V.

AU - Wilson, William T.

AU - Wearing, Scott C.

AU - Picard, Frederic

AU - Riches, Philip E.

AU - Deakin, Angela H.

PY - 2012/9/1

Y1 - 2012/9/1

N2 - Clinical laxity tests are used for assessing knee ligament injuries and for soft tissue balancing in total knee arthroplasty. This study reports the development and validation of a quantitative technique of assessing collateral knee laxitythrough accurate measurement of potential variables during routine clinicalexamination. The hypothesis was that standardisation of a clinical stress testwould result in a repeatable range of laxity measurements.Non- invasiveinfrared tracking technology with kinematic registration of joint centres gavereal-time measurement of both coronal and sagittal mechanical tibiofemoralalignment. Knee flexion, moment arm and magnitude of the applied force were all measured and standardised. Three clinicians then performed six knee laxityexaminations on a single volunteer using a target moment of 18Nm. Standardised laxity measurements had small standard deviations (within 1.1°) for each clinician and similar mean values between clinicians, with the valgus laxityassessment (mean of 3°) being slightly more consistent than varus (means of 4°or 5°).The manual technique of coronal knee laxity assessment was successfullyquantified and standardised, leading to a narrow range of measurements (withinthe accuracy of the measurement system). Minimising the subjective variables ofclinical examination could improve current knowledge of soft tissue kneebehaviour.

AB - Clinical laxity tests are used for assessing knee ligament injuries and for soft tissue balancing in total knee arthroplasty. This study reports the development and validation of a quantitative technique of assessing collateral knee laxitythrough accurate measurement of potential variables during routine clinicalexamination. The hypothesis was that standardisation of a clinical stress testwould result in a repeatable range of laxity measurements.Non- invasiveinfrared tracking technology with kinematic registration of joint centres gavereal-time measurement of both coronal and sagittal mechanical tibiofemoralalignment. Knee flexion, moment arm and magnitude of the applied force were all measured and standardised. Three clinicians then performed six knee laxityexaminations on a single volunteer using a target moment of 18Nm. Standardised laxity measurements had small standard deviations (within 1.1°) for each clinician and similar mean values between clinicians, with the valgus laxityassessment (mean of 3°) being slightly more consistent than varus (means of 4°or 5°).The manual technique of coronal knee laxity assessment was successfullyquantified and standardised, leading to a narrow range of measurements (withinthe accuracy of the measurement system). Minimising the subjective variables ofclinical examination could improve current knowledge of soft tissue kneebehaviour.

KW - clinical assessment

KW - knee laxity

KW - ligament injuries

KW - non-invasive assessment

KW - total knee arthroplasty

UR - http://www.scopus.com/inward/record.url?scp=84867875354&partnerID=8YFLogxK

U2 - 10.1177/0954411912451814

DO - 10.1177/0954411912451814

M3 - Article

VL - 226

SP - 699

EP - 708

JO - Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine

JF - Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine

SN - 0954-4119

IS - 9

ER -