Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
The accuracy of clinical examination of rotational and sagittal laxity of the knee
Purpose: This study evaluates the accuracy and reliability of clinical examination for knee laxity in degrees and millimetres when compared to movement measured by computer-assisted navigation. Methods: A cadaver lower limb was connected to a computer assisted knee surgery system (CAS) and calibrate...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
University of Cape Town
2020
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867613206210412545 |
|---|---|
| access_status_str | Open Access |
| author | Bezuidenhout, Carel Willem |
| author2 | Held, Michael |
| author_browse | Bezuidenhout, Carel Willem Held, Michael |
| author_facet | Held, Michael Bezuidenhout, Carel Willem |
| author_sort | Bezuidenhout, Carel Willem |
| collection | Thesis |
| description | Purpose: This study evaluates the accuracy and reliability of clinical examination for knee laxity in degrees and millimetres when compared to movement measured by computer-assisted navigation. Methods: A cadaver lower limb was connected to a computer assisted knee surgery system (CAS) and calibrated through a mini medial parapatellar arthrotomy. Examiners estimated millimetres of sagittal and degrees of rotational laxity of the knee at 30º and 90º of knee flexion. This examination was done in the ligamentous intact knee and again after sequential release of the anterior cruciate ligament (ACL) and anterolateral ligament (ALL). The clinical assessments were compared with measurements produced by CAS. Intraclass correlation coefficient (ICC), correlation coefficient (CC) and Bland Altman plots were used to compare and summarize the data. Results: At least 21 participants assessed the knee after each sequence of ligament sectioning. The reliability of clinical examination when correlated with the CAS measurements was poor for all examination groups. The ICC was poor for sagittal laxity at 30º (R=0.02; p=0.04), rotational laxity at 30º and 90º (R=0.17; p=0.04) (R=0.3; p=0.04) respectively and sagittal laxity at 90º(R=0.47; p=0.04). The correlation coefficients were very weak for sagittal laxity at 30º (R=0.09; p=0.46), weak for rotational laxity at 30º (R=0.24; p=0.06) and 90º (R=0.3; p=0.01) and moderately weak for sagittal laxity at 90º(R=0.4; p=0.001). Clinical examination was only accurate in the detection of sagittal laxity greater than 11.6mm at 30°, and greater than 9.4mm at 90°. Clinical examination for rotational laxity was only accurate for rotational instability greater than 27.7° at 30°flexion, and 28.9° rotation at 90°. Conclusions: There was poor reliability and weak correlation between clinician estimated sagittal and rotational laxity and measurements produced by CAS. This study showed that participants could not accurately estimate laxity in degrees and millimetres and supports the need for accurate objective knee laxity measurements. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/32462 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:27.580Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | University of Cape Town |
| publisherStr | University of Cape Town |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/32462 The accuracy of clinical examination of rotational and sagittal laxity of the knee Bezuidenhout, Carel Willem Held, Michael Orthopaedic Surgery Purpose: This study evaluates the accuracy and reliability of clinical examination for knee laxity in degrees and millimetres when compared to movement measured by computer-assisted navigation. Methods: A cadaver lower limb was connected to a computer assisted knee surgery system (CAS) and calibrated through a mini medial parapatellar arthrotomy. Examiners estimated millimetres of sagittal and degrees of rotational laxity of the knee at 30º and 90º of knee flexion. This examination was done in the ligamentous intact knee and again after sequential release of the anterior cruciate ligament (ACL) and anterolateral ligament (ALL). The clinical assessments were compared with measurements produced by CAS. Intraclass correlation coefficient (ICC), correlation coefficient (CC) and Bland Altman plots were used to compare and summarize the data. Results: At least 21 participants assessed the knee after each sequence of ligament sectioning. The reliability of clinical examination when correlated with the CAS measurements was poor for all examination groups. The ICC was poor for sagittal laxity at 30º (R=0.02; p=0.04), rotational laxity at 30º and 90º (R=0.17; p=0.04) (R=0.3; p=0.04) respectively and sagittal laxity at 90º(R=0.47; p=0.04). The correlation coefficients were very weak for sagittal laxity at 30º (R=0.09; p=0.46), weak for rotational laxity at 30º (R=0.24; p=0.06) and 90º (R=0.3; p=0.01) and moderately weak for sagittal laxity at 90º(R=0.4; p=0.001). Clinical examination was only accurate in the detection of sagittal laxity greater than 11.6mm at 30°, and greater than 9.4mm at 90°. Clinical examination for rotational laxity was only accurate for rotational instability greater than 27.7° at 30°flexion, and 28.9° rotation at 90°. Conclusions: There was poor reliability and weak correlation between clinician estimated sagittal and rotational laxity and measurements produced by CAS. This study showed that participants could not accurately estimate laxity in degrees and millimetres and supports the need for accurate objective knee laxity measurements. 2020-12-30T10:17:58Z 2020-12-30T10:17:58Z 2020 Master Thesis Masters MMed http://hdl.handle.net/11427/32462 eng application/pdf University of Cape Town Division of Orthopaedic Surgery Faculty of Health Sciences |
| spellingShingle | Orthopaedic Surgery Bezuidenhout, Carel Willem The accuracy of clinical examination of rotational and sagittal laxity of the knee |
| thesis_degree_str | Master's |
| title | The accuracy of clinical examination of rotational and sagittal laxity of the knee |
| title_full | The accuracy of clinical examination of rotational and sagittal laxity of the knee |
| title_fullStr | The accuracy of clinical examination of rotational and sagittal laxity of the knee |
| title_full_unstemmed | The accuracy of clinical examination of rotational and sagittal laxity of the knee |
| title_short | The accuracy of clinical examination of rotational and sagittal laxity of the knee |
| title_sort | accuracy of clinical examination of rotational and sagittal laxity of the knee |
| topic | Orthopaedic Surgery |
| url | http://hdl.handle.net/11427/32462 |
| work_keys_str_mv | AT bezuidenhoutcarelwillem theaccuracyofclinicalexaminationofrotationalandsagittallaxityoftheknee AT bezuidenhoutcarelwillem accuracyofclinicalexaminationofrotationalandsagittallaxityoftheknee |