A novel digital arthrometer to measure anterior tibial translation

Wu, Danni; Wang, Donghai; Han, Yaling; Guo, Luqi; Wang, Shaobai

doi:10.1186/s13018-022-03497-4

Cited by 3 publications

(5 citation statements)

References 28 publications

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“…The straightforward and adaptable operation minimizes measurement inaccuracies that the examiner may have caused. Previous studies have confirmed the excellent intra-and interrater reliability (intraclass correlation, >0.9) of the Ligs arthrometer (Chen et al, 2022;Wu et al, 2023). Second, for the patient, the operation is more flexible because the rocker at the end of the main unit controls the load application.…”

Section: Figurementioning

confidence: 81%

“…Load and displacement were input into the Ligs storage unit by using digital sensor with a sampling rate of 30Hz. Displacement recording was initiated when the load exceeded 20 N to attenuate the impact of muscle tissue ( Wu et al, 2023 ). The load is accurate to 1 N, and the displacement is accurate to 0.1 mm.…”

Section: Methodsmentioning

confidence: 99%

“…The interrater reliability and the intrarater reliability were considered excellent with ICC score of 0.91 and 0.94. The sensitivity and specificity of Ligs for the identification of ACL injuries were 87% and 73% at a load of 150N ( Wu et al, 2023 ). In the present study, we compared differences in knee laxity between healthy individuals and patients with ACL injuries by using this novel digital arthrometer.…”

Section: Introductionmentioning

confidence: 99%

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Subregional analysis of joint stiffness facilitates insight into ligamentous laxity after ACL injury

Wu,

Zhao,

et al. 2023

Front. Bioeng. Biotechnol.

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Purpose: Increased incidence of anterior cruciate ligament injuries has amplified the need for quantitative research in clinical and academic settings. We used a novel digital arthrometer to measure knee laxity in healthy people and patients with anterior cruciate ligament injuries. Changes in stiffness were also assessed to develop new indicators for detecting anterior cruciate ligament injury. The purpose of this study was to use arthrometer to measure the quantitative indicator of knee laxity, bringing clinicians a new perspective on how to identify injury to the ACL.Methods: In this cross-sectional study, anterior tibial displacement under continuous loading was measured using a novel digital arthrometer in 30 patients with unilateral anterior cruciate ligament injury and 30 healthy controls. Load-displacement curves were plotted, using real-time load and displacement changes. Stiffness was defined by the slope of the applied load to tibial displacement. Anterior tibial displacement and instantaneous stiffness values under different loads were compared. The restricting contribution of the anterior cruciate ligament transformed the displacement-stiffness curve from a sharp decrease to a stable increase, resulting in a minimum stiffness value. Using the minimum stiffness as the turning point, the load-displacement curve was divided into regions 1 and 2. The two regions’ stiffness changes were compared. Based on the findings, receiver operating characteristic curves were plotted and the area under the curve was calculated to estimate the diagnostic accuracy.Results: Anterior tibial displacement was significantly greater in the anterior cruciate ligament injury group than in the controls under each 10-N increase load (p < 0.05). In the anterior cruciate ligament injury group, instantaneous stiffness was significantly lower on the injured side than on the healthy side (p < 0.05). In the two regions of the load-displacement curve, stiffness was significantly lower in the anterior cruciate ligament injury group than in the control group (all, p < 0.05). Receiver operating characteristic curves were plotted, using changes in stiffness under the two regions in both groups. Stiffness in region 2 had the largest area under the curve (0.94; 95% CI, 0.88–0.99). Using the cut-off value of 9.62 N/mm to detect ACL injury, the sensitivity and specificity were 93% and 82%, respectively.Conclusion: Our investigation of ligament stiffness provides novel insights into the properties of knee laxity. Stiffness in the later stages of increased loading <9.62 N/mm could be a valid indicator for identifying knee laxity.

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Section: Figurementioning

confidence: 81%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subregional analysis of joint stiffness facilitates insight into ligamentous laxity after ACL injury

Wu,

Zhao,

et al. 2023

Front. Bioeng. Biotechnol.

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“…The authors found higher accuracy than KT 2000 (sensitivity: 86% vs 83%; specificity: 95.5% vs 88.5%), using a threshold of 3 mm as in the study. Wu et al [ 28 ], recently tested a new automatic knee arthrometer (Ligs Innomotion). At a load of 150 N (comparable to the MMT in the present study), the authors found the maximum AUC (0.857) and a sensitivity and specificity of 0.87 and 0.73, respectively.…”

Section: Discussionmentioning

confidence: 99%

BLU‐DAT: a new reliable and accurate arthrometer for measuring anterior knee laxity

Colosio

Scaini

Motta

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose Although many arthrometers have been developed to assess anterior knee laxity, reliability and diagnostic accuracy of these devices are still debated. The aim of the present study was to evaluate the validity of a new arthrometer in the outpatient setting, with the hypothesis that it had good validity in terms of reliability and diagnostic accuracy. Methods Seventy-eight subjects (39 with ACL injury and 39 with normal ACL) were tested. ATT was assessed by means of the Lachman test at 30° of flexion with a new testing device (BLU-DAT) under three different loading conditions: 7 kg (69 N), 9 kg (88 N) and maximum (MMT). The tests were performed on both knees to obtain SSD. In the ACL injury group, the tests were performed by two examiners and one of them repeated a second test series. Inter- and intra-observer reliability were assessed with the intraclass correlation coefficients (ICCs) for the average SSD measures. In the normal-ACL group, the analysis was performed with the same testing setup. Side-to-side difference measures of the two groups at every loading condition were compared by Student’s t test. Data of test series were dichotomized based on the threshold value of 3-mm SSD as pathological ATT and 2 × 2 contingency tables were used to assess diagnostic accuracy. Results The ICCs for intra-observer reliability at 7-kg (69 N), 9-kg (88 N) and MMT measurements were 0.781, 0.855 and 0.913, respectively. The ICC for inter-observer reliability at 7-kg (69 N), 9-kg (88 N) and MMT measurements were 0.701, 0.845 and 0.834, respectively. Comparison between the two groups showed a significant mean difference ranging from 3.4 mm for 7-kg (69 N) load to 4.6 mm for MMT. Overall accuracy ranged from 84.6% for 7-kg load to 98.7% for MMT. Conclusion The BLU-DAT has proven to be an instrument with good intra- and inter-observer reliability and very good accuracy in the diagnosis of ACL injuries in the outpatient setting. So, the BLU-DAT can be a new useful tool in everyday clinical practice to assist in the diagnosis of ACL injury. Level of evidence II.

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“…A physical therapist unaware of the study measured anterior knee laxity before the surgery using the Ligs digital arthrometer (Innomotion Inc) at 90 N, 120 N, and 150 N thrust loads. 27,52,56 During the measurement, simultaneous stress radiography was conducted by a trained radiology technician with the assistance of the arthrometer to obtain a true lateral view radiograph of the knee at 30°o f flexion. 9,24 Anterior tibial translation was measured on the true lateral view radiograph by the same senior musculoskeletal radiologist using the method described by z Beldame et al 4 The side-to-side difference (SSD) in knee laxity measured by the arthrometer and stress radiography at 90 N, 120 N, and 150 N was calculated, respectively.…”

Section: Patient Assessmentmentioning

confidence: 99%

Correlation Between the Location and Distance of Kissing Contusions and Knee Laxity in Acute Noncontact ACL Injury

Li,

Mao,

Wang

et al. 2023

Am J Sports Med

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Background: Bone bruise (BB) and kissing contusion are common features of acute anterior cruciate ligament (ACL) injury on magnetic resonance imaging (MRI). The correlation between the location and distance of kissing contusions and knee laxity remains unclear. Purpose: To determine the significance of different patterns of BB in acute noncontact ACL injury and assess the correlation between the location and distance of kissing contusions and the severity of knee laxity. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 205 patients with acute noncontact ACL injury undergoing arthroscopic treatment between January 2021 and May 2022 were included in this retrospective analysis. Patients were grouped according to the different patterns of BB. The type of ACL injury and concomitant injuries were analyzed on MRI and confirmed by arthroscopy. Anterior knee laxity was assessed by the Ligs digital arthrometer and stress radiography, and rotational knee laxity was assessed by the intraoperative pivot-shift test. The MRI parameters of the location and distance of kissing contusions were measured to assess their correlations with the severity of knee laxity. Results: Of the 205 patients with acute noncontact ACL injury, 38 were in the non-BB group and 167 were in the BB group, the latter including 32 with the isolated BB on the lateral tibial plateau and 135 with kissing contusions. There was no significant difference in the mean time from initial injury to MRI scan between the non-BB group and the BB group (14.34 ± 2.92 vs 15.17 ± 2.86 days; P = .109) or between the isolated BB subgroup and the kissing contusion subgroup (14.94 ± 2.92 vs 15.23 ± 2.85 days; P = .605). The side-to-side difference (SSD) in anterior knee laxity and the incidences of complete ACL injury, concomitant injuries, and high-grade pivot-shift test were significantly higher in the BB group than in the non-BB group, and in the kissing contusion subgroup compared with the isolated BB subgroup. The kissing contusion index of the lateral femoral condyle (LFC) and the sagittal distance of kissing contusions were significantly correlated with the SSD in anterior knee laxity and the grade of pivot-shift test ( P < .001). Conclusion: The presence of BB, in particular the appearance of kissing contusions, was related to greater knee laxity and higher incidences of complete ACL injury and concomitant injuries in acute noncontact ACL injury. For patients with kissing contusions, as the location of BB on the LFC moved forward and the distance between kissing contusions increased, anterior and rotational knee laxity became more serious.

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A novel digital arthrometer to measure anterior tibial translation

Cited by 3 publications

References 28 publications

Subregional analysis of joint stiffness facilitates insight into ligamentous laxity after ACL injury

Subregional analysis of joint stiffness facilitates insight into ligamentous laxity after ACL injury

BLU‐DAT: a new reliable and accurate arthrometer for measuring anterior knee laxity

Correlation Between the Location and Distance of Kissing Contusions and Knee Laxity in Acute Noncontact ACL Injury

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