Reliability of Navigated Knee Stability Examination

Pearle, Andrew D.; Solomon, Daniel J.; Wanich, Tony; Moreau–Gaudry, Alexandre; Granchi, Carinne; Wickiewicz, Thomas L.; Warren, Russell F.

doi:10.1177/0363546507300821

Cited by 99 publications

(104 citation statements)

References 41 publications

Supporting

Mentioning

100

Contrasting

Unclassified

Order By: Relevance

“…The utilization of a surgical navigation system during clinical laxity examinations was reliable and repeatable; high intraclass correlation coefficients (0.998) were recorded for this surgical navigation system in comparison to a robotic manipulator [34].…”

Section: Methodsmentioning

confidence: 86%

“…We chose a difference of 3 mm as a clinically relevant value based on previous kinematic data obtained during examination of ACL-deficient knees studying similar parameters [6,25,31,33,34]. The power analysis indicated five specimens would be needed per group to discern a difference of 3 mm in compartmental translation per condition.…”

Section: Methodsmentioning

confidence: 99%

“…We reported the maximum tibial translations and rotation during the RPS maneuver as the difference between reference motion path and RPS motion path in the medial and lateral compartments [5]. The utilization of a surgical navigation system during clinical laxity examinations was both reliable and repeatable [34]. A single surgeon (FAP) performed all surgical dissections.…”

Section: Methodsmentioning

confidence: 99%

“…The multiplanar instability patterns present in the ACL-deficient knee have been previously described [9,[33][34][35]. Additionally, there have been investigations related to the uniplanar kinematics of the PCL-and PLCdeficient knee [3,8,12,13,18,24,26,27,30].…”

Section: Introductionmentioning

confidence: 93%

See 3 more Smart Citations

Posterior Cruciate Ligament and Posterolateral Corner Deficiency Results in a Reverse Pivot Shift

Petrigliano

Lane

Suero

et al. 2012

Clinical Orthopaedics &Amp; Related Research

Self Cite

View full text Add to dashboard Cite

Background As measured via static stability tests, the PCL is the dominant restraint to posterior tibial translation while the posterolateral corner is the dominant restraint to external tibial rotation. However, these uniplanar static tests may not predict multiplanar instability. The reverse pivot shift is a dynamic examination maneuver that may identify complex knee instability. Questions/purposes In this cadaver study, we asked whether (1) isolated sectioning or (2) combined sectioning of the PCL and posterolateral corner increased the magnitude of the reverse pivot shift and (3) the magnitude of the reverse pivot shift correlated with static external rotation or posterior drawer testing. Methods In Group I, we sectioned the PCL followed by structures of the posterolateral corner. In Group II, we sectioned the posterolateral corner structures before sectioning the PCL. We performed posterior drawer, external rotation tests, and mechanized reverse pivot shift for each specimen under each condition and measured translations via navigation. Results Isolated sectioning of the PCL or posterolateral corner had no effect on the reverse pivot shift. Conversely, combined sectioning of the PCL and posterolateral corner structures increased the magnitude of the reverse pivot shift. The magnitude of the reverse pivot shift correlated with the posterior drawer and external rotation tests. Conclusions Combined sectioning of the PCL and posterolateral corner was required to cause an increase in the magnitude of the mechanized reverse pivot shift. The reverse pivot shift correlated with both static measures of stability. Clinical RelevanceCombined injury to the PCL and posterolateral corner should be considered in the presence of a positive reverse pivot shift.

show abstract

Section: Methodsmentioning

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

See 2 more Smart Citations

Posterior Cruciate Ligament and Posterolateral Corner Deficiency Results in a Reverse Pivot Shift

Petrigliano

Lane

Suero

et al. 2012

Clinical Orthopaedics &Amp; Related Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…The navigation system remains the gold standard for the measure of anterior-posterior knee laxity due to its precision, validity and accuracy [36,45,[63][64][65]. Pearls et al [65] investigated the reliability and repeatability of using a knee navigation system in knee instability examination by comparing the navigation system to a robotic testing system.…”

Section: Navigation Systemsmentioning

confidence: 99%

An Extensive Evaluation of Different Knee Stability Assessment Measures: A Systematic Review

Abulhasan

Snow

Anley

et al. 2016

JFMK

View full text Add to dashboard Cite

Abstract:Re-injury to a recently rehabilitated or operated knee is a common occurrence that can result in significant loss of function. Knee stability measures have been used to diagnose and assess knee stability before and after rehabilitation interventions. Here, we systematically review the literature and evaluate the different anterior-posterior and rotational knee stability measures currently in use. A computer-assisted literature search of the Medline, CINAHL, EMBASE, PubMed and Cochrane databases was conducted using keywords related to knee stability measures. In a second step, we conducted a manual search of the references cited in these articles to capture any studies that may have been missed in the searched databases. The literature search strategy identified a total of 574 potential studies. After revisiting the titles and abstracts, 34 full-text articles met the inclusion criteria and were included in this review. Most articles compared knee stability measures, whilst other studies assessed their sensitivity and specificity. Several techniques and devices used to measure knee stability are reported in the literature. However, there are only a limited number of quality studies where these techniques and/or devices have been evaluated. Further development and investigation with high quality study designs is necessary to robustly evaluate the existing devices/techniques.

show abstract

Assessment of the accuracy of infrared and electromagnetic navigation using an industrial robot: Which factors are influencing the accuracy of navigation?

Liodakis

Chu

Westphal

et al. 2011

Journal Orthopaedic Research

View full text Add to dashboard Cite

Our objectives were to detect factors that influence the accuracy of surgical navigation (magnitude of deformity, plane of deformity, position of the navigation bases) and compare the accuracy of infrared with electromagnetic navigation. Human cadaveric femora were used. A robot connected with a computer moved one of the bony fragments in a desired direction. The bases of the infrared navigation (BrainLab) and the receivers of the electromagnetic device (Fastrak-Pohlemus) were attached to the proximal and distal parts of the bone. For the first part of the study, deformities were classified in eight groups (e.g., 0 to 5 8 ). For the second part, the bases were initially placed near the osteotomy and then far away. The mean absolute differences between both navigation system measurements and the robotic angles were significantly affected by the magnitude of angulation with better accuracy for smaller angulations (p < 0.001). The accuracy of infrared navigation was significantly better in the frontal and sagittal plane. Changing the position of the navigation bases near and far away from the deformity apex had no significant effect on the accuracy of infrared navigation; however, it influenced the accuracy of electromagnetic navigation in the frontal plane (p < 0.001). In conclusion, the use of infrared navigation systems for corrections of small angulation-deformities in the frontal or sagittal plane provides the most accurate results, irrespectively from the positioning of the navigation bases. Keywords: robot-assisted surgery; electromagnetic navigation; infrared navigation; accuracy; deformityThe main goal of computer assisted orthopaedic techniques is to improve the precision and accuracy by which procedures can be executed. This in turn might lead to improved outcomes and patient satisfaction, decreased complication rates, decreased long-term costs and adoption of less invasive approaches. [1][2][3] Computer navigation is used to track the position and orientation of objects, 4 such as the tip of a pointer or a surgical tool on a preoperative or intraoperative image after registration of landmarks or surfaces on anatomical structures. [4][5][6][7] Instant tracking of objects can be achieved with infrared cameras, electromagnetic navigation, or acoustic technology. 5,8 The most popular technology used in orthopaedic practice is infrared tracking of light emitting diodes (LEDs) attached to rigid bodies. The measurement of position changes is performed by computing the intersection of the three planes corresponding to each camera. 4 The main disadvantages are cost and the need for a line of sight between the object and the camera. Therefore, availability is limited. 4,5 Another interesting modality recently introduced into total knee arthroplasty, but not yet a standard procedure, is electromagnetic navigation. 9 It depends on the generation of an electromagnetic field to attain positional awareness. The main disadvantage of this technology is the interference of magnetic metals with the measurements;...

show abstract

Reliability of Navigated Knee Stability Examination

Abstract: Surgical navigation may refine the diagnostic evaluation of knee instability.

Cited by 99 publications

References 41 publications

Posterior Cruciate Ligament and Posterolateral Corner Deficiency Results in a Reverse Pivot Shift

Posterior Cruciate Ligament and Posterolateral Corner Deficiency Results in a Reverse Pivot Shift

An Extensive Evaluation of Different Knee Stability Assessment Measures: A Systematic Review

Assessment of the accuracy of infrared and electromagnetic navigation using an industrial robot: Which factors are influencing the accuracy of navigation?

Contact Info

Product

Resources

About