The evaluation of Rolimeter, KLT, KiRA and KT-1000 arthrometer in healthy individuals shows acceptable intra-rater but poor inter-rater reliability in the measurement of anterior tibial knee translation

Abstract

Purpose To assess measurement equivalence, inter- and intra-rater reliability, standard error of measurements (SEM) and false positive measurements (FPM) of four different knee arthrometers (KLT,Karl Storz; KiRA, I + ; KT-1000 MEDmetric Corp; Rolimeter, Aircast) in healthy patients. Methods Four different investigators (two advanced (AR) and two beginners (BR)) examined 12 participants with healthy knees at two time points with regards to anterior tibial translation (ATT) and side-to-side difference (SSD). Test equivalence was assessed using the TOST (two-one-sided t test) procedure with ± 1 mm equivalence boundaries. Intraclass correlation coefficients (ICCs) were calculated using two-way mixed effects models. Furthermore, false positive-(SSD > 3 mm) and SEMs were assessed. Results A total of 2304 Lachman Tests were performed. Between-rater SSDs were equivalent between AR and BR raters for the Rolimeter only. Inter-rater ICC values (SSD, ATT) were graded as “poor” to “moderate” for all devices. Equivalent test–retest results were observed for all raters using the Rolimeter, KLT and KT-1000, whereas measurement consistency with KiRA was given in the advanced examiners group only. Intra-rater ICC values (Range: SSD, ATT) were graded as “poor” to “moderate” for SSD values and “moderate” to “good” for ATT. SEMs were lowest for the Rolimeter and highest for KiRA. FPM were never obtained with the Rolimeter (0%), twice (2.1%) with the KT-1000, three times (3.1%) with the KLT and 33 times (34.4%) using KiRA. Conclusion There is acceptable intra-rater but poor inter-rater reliability with all tested arthrometers. Measures of knee laxity are comparable between Rolimeter, KLT and KT-1000 but higher for KiRA. Clinically, the present study shows that repeated arthrometry measurements should always be performed by the same investigators.

Fixed-loop vs. adjustable-loop cortical button devices for femoral fixation in ACL reconstruction – a systematic review and meta-analysis

“…The studies by Choi et al [ 9 ] and Firat et al [ 14 ] stated that the KT-1000 measurements were performed at maximal force as opposed to the studies by Ranjan et al [ 34 ] and Djordjevíc et al [ 11 ], who did not specify the force applied. The inter-reader reliability with the KT-1000 arthrometer was found poor by Runer et al [ 35 ], who stated that this could partially be explained by differences in the force that the assessors applied. The meta-analysis conducted on PROMs showed that ALDs did not improve the PROMs compared to the FLDs when using either the IKDC or the Lysholm score.…”

Effects of the menstrual cycle phase on anterior cruciate ligament neuromuscular and biomechanical injury risk surrogates in eumenorrheic and naturally menstruating women: A systematic review

“…Therefore, monitoring female athletes’ knee laxity changes could be a viable strategy to infer potential KJLs changes and potential ACL injury risk throughout the MC. This can be done using an arthrometer [ 33 , 34 , 83 , 84 ], rolimeter [ 85 , 86 ], ultrasound [ 87 ], radiography [ 88 ], or wearable accelerometers [ 84 ].…”

Evaluation of knee joint stability after ACL reconstruction with an ST/GR graft using an Aircast Rolimeter

“…Proper mechanical and functional stabilization guarantees the ability to freely perform the most complex motor activities. The Rolimeter is an accurate, simple, and economical device that provides a quantitative assessment of the anterior tibial displacement [14]. The results of many authors, including Ganko et al [15], indicate that the Rolimeter is a reliable device for the objective assessment of knee laxity.…”

“…The device allows for the quantitative examination of the tibia translation relative to the thigh in standard anterior drawer tests and Lachman. For the test to be precise and repeatable, it is important that it is always performed by the same person [14,15].…”