A comparison of Telos™ stress radiography versus Rolimeter™ in the diagnosis of different patterns of anterior cruciate ligament tears

Abstract

Level III (case-control study).

Stress Radiography for the Diagnosis of Knee Ligament Injuries: A Systematic Review

“…Panisset [34] Rolimeter and pivot shift test Telos stress radiography provides greater sensitivity relative to Rolimeter with similar specificity; however, Telos specificity was superior when used in combination with the pivot shift test PCL Hewett [14] KT-1000 and posterior drawer Stress radiography is superior to both the KT-1000 and the posterior drawer in assessing for presence or absence of a complete PCL tear Finally, results of the comparative diagnostic studies included in this review yield no clear consensus on the use of stress radiography compared with other diagnostic tests for knee ligament injuries. The ability to draw conclusions is limited even among studies that compared stress radiography with the same alternative diagnostic technique.…”

“…Three of five studies comparing stress radiography with the KT-1000 or KT-2000 (MEDmetric Corporation, San Diego, CA, USA) for the diagnosis of AP instability concluded that stress radiography is superior, whereas the other two studies showed excellent but equivalent diagnostic ability [7,14,29,31,45]. For diagnosis of ACL injury, stress radiography correlated with results of the pivot shift test but not the Lachman's test [15], was equivalent to the GNRB computerized arthrometer [2], and offered greater sensitivity but similar specificity to the Rolimeter [34]. For the assessment of multiligament injury, stress radiography was more accurate than examination under anesthesia and clinical examination [18].…”

Anterior cruciate ligament assessment using arthrometry and stress imaging

“…Different diagnostic thresholds have been reported in the literature ranging from SSD of 2 to 5 mm [14,17,21]. In patients with complete ACL tear, Panisset et al found average SSD to be 7.4 ± 4.3 mm and used SSD >5 mm as their diagnostic threshold using Telos stress imaging (Sn 80.9 %, sp 81.8 %) [5]. Beldame et al instead used a diagnostic threshold of 4 mm with Telos stress imaging (Son 59 %, Sp 90 %) [2].…”

“…Another simple technique involves placing a sandbag onto the patient's leg in an appropriate position, typically weighing anywhere from 3 to 9 kg [9,11,15]. The Telos apparatus is also commonly used [2,5,[16][17][18][19]. This is a device which holds the femur and tibia in a fixed position, and then applies a reproducible force to the posterior tibia, producing anterior tibial translation.…”

“…Alone, the diagnostic value of laximetry appears comparable to classic exam maneuvers such as the Lachman's or pivot-shift tests, but the combination of both measures is superior [5,28,43,86,87]. Some literature suggests that this combination exceeds the diagnostic abilities of MRI, thus potentially obviating the need for the added time and cost of advanced imaging [5,28].…”