Skip to main content
SpringerLink
Log in

Aktueller Stand der instrumentellen Messung der Knielaxität

Current state of instrumental measurement of knee laxity

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Um die subjektiven manuellen Untersuchungsergebnisse bei Knieinstabilität zu objektivieren und neue Operationstechniken überprüfen zu können, werden zuverlässige apparative Messverfahren zur Bestimmung der Laxität unter Berücksichtigung der Rotation und a.p.-Translation benötigt. Die bisher häufig verwendeten kommerziell verfügbaren Arthrometer sind in der Lage, die a.p.-Translation objektiv zu messen, die Rotationskomponente wird jedoch nicht berücksichtigt. Kadaverstudien zur Bestimmung der Laxität sind in der Grundlagenforschung richtungsweisend und wichtig. Die Computernavigation liefert zuverlässige Ergebnisse, dient aber eher der Validierung von Operationstechniken. Für die Anwendung in der klinischen Praxis sind einfache, portable Geräte in Vorbereitung. Für die Forschung sind Geräte zur digitalen Erfassung von 6 Freiheitsgraden und zur Registrierung der biomechanischen Eigenschaften sinnvoll.

Abstract

In order to objectify manual tests of knee instability and to evaluate new surgical techniques, reliable technical measurement methods are needed to determine knee laxity taking the rotation and AP translation into account. Commercially available arthrometers are able to measure the AP translation objectively, but the rotational component is not considered. Cadaver studies for evaluation of testing systems are important for basic research. Computer navigation provides reliable results but is more suitable as a validation tool for surgical techniques. For application in clinical practice simple, portable devices are in preparation. For research digital recording equipment with six degrees of freedom and for the registration of biomechanical properties are useful.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5

Literatur

  1. Almquist PO, Arnbjörnsson A, Zätterström R et al (2002) Evaluation of an external device measuring knee joint rotation: an in vivo study with simultaneous Roentgen stereometric analysis. J Orthop Res 20(3):427–432

    Article  PubMed  Google Scholar 

  2. Bignozzi S, Zaffagnini S, Lopomo N et al (2009) Clinical relevance of static and dynamic tests after anatomical double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc, in press

  3. Bleday RM, Fanelli GC, Giannotti BF et al (1998) Instrumented measurement of the posterolateral corner. Arthroscopy 14(5):489–494

    Article  PubMed  CAS  Google Scholar 

  4. Bull AM, Andersen HN, Basso O et al (1999) Incidence and mechanism of the pivot shift. An in vitro study. Clin Orthop Relat Res 363:219–231

    Article  PubMed  Google Scholar 

  5. Bull AM, Amis AA (1998) The pivot shift phenomenon: a clinical and biomechanical perspective. Knee 5:141–158

    Article  Google Scholar 

  6. Colombet P, Robinson J, Christel P et al (2006) Using navigation to measure rotation kinematics during ACL reconstruction. Clin Orthop Relat Res 454:59–65

    Article  Google Scholar 

  7. Csintalan RP, Ehsan A, McGarry MH et al (2006) Biomechanical and anatomical effects of an external rotational torque applied to the knee: a cadaveric study. Am J Sports Med 34(10):1623–1629

    Article  PubMed  Google Scholar 

  8. Daniel DM, Stone ML, Sachs R, Malcolm L (1985) Instrumented measurement of anterior knee laxity in patients with acute anterior cruciate ligament disruption. Am J Sports Med 13(6):401–407

    Article  PubMed  CAS  Google Scholar 

  9. Diermann N, Schumacher T, Schanz S et al (2009) Rotational instability of the knee: internal tibial rotation under a simulated pivot shift test. Arch Orthop Trauma Surg 129:353–358

    Article  PubMed  Google Scholar 

  10. Hoshino Y, Kuroda R, Nagamune K et al (2007) In vivo measurement of the pivot-shift test in the anterior cruciate ligament-deficient knee using an electromagnetic device. Am J Sports Med 35(7):1098–1104

    Article  PubMed  Google Scholar 

  11. Jardin C, Chantelot C, Migaud H et al (1999) Reliability of the KT-1000 arthrometer in measuring anterior laxity of the knee: comparative analysis with Telos of 48 reconstructions of the anterior cruciate ligament and intra- and interobserver reproducibility. Rev Chir Orthop Reparatrice Appar Mot Nov 85(7):698–707

    CAS  Google Scholar 

  12. Katz JW, Fingeroth RJ (1986) The diagnostic accuracy of ruptures of the anterior cruciate ligament comparing the Lachman test, the anterior drawer sign, and the pivot shift test in acute and chronic knee injuries. Am J Sports Med 14(1):88–91

    Article  PubMed  CAS  Google Scholar 

  13. Kocher MS, Steadman R, Briggs KK et al (2004) Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction. Am J Sports Med 32(3):629–634

    Article  PubMed  Google Scholar 

  14. Kubo S, Muratsu H, Yoshiya S et al (2006) Reliability and usefulness of a new in vivo measurement system of the pivot shift. Clin Orthop Relat Res 454:54–58

    Article  Google Scholar 

  15. Lane CG, Warren RF, Stanford FC et al (2008) In vivo analysis of the pivot shift phenomenon during computer navigated ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 16:487–492

    Article  PubMed  Google Scholar 

  16. Lopomo N, Zaffagnini S, Bignozzi S et al (2009) Pivot-shift test: analysis and quantification of knee laxity parameters using a navigation system. J Orthop Res, 2009 Jul 29 [Epub ahead of print]

  17. Lopomo N, Bignozzi S, Martinelli S et al (2009) Reliability of a navigation system for intra-operative evaluation of anterior-posterior knee joint laxity. Comput Biol Med Mar 39(3):280–285

    Article  Google Scholar 

  18. Pugh L, Mascarenhas R, Arneja S et al (2009) Current concepts in instrumented knee-laxity testing. Am J Sports Med 37(1):199–210

    Article  PubMed  Google Scholar 

  19. Quinn TP, Mote CD, Skinner HB (1991) The effect of ankle constraint on the torsional laxity of the knee during internal-external rotation of the foot. J Appl Biomech 24(7):511–525

    Article  CAS  Google Scholar 

  20. Rick PC, Ehsan A, McGarry M et al (2006) Biomechanical and anatomical effects of an external rotational torque applied to the knee. A cadaveric study. Am J Sports Med 34(10):1623–1629

    Article  Google Scholar 

  21. Robert H, Nouveau S, Gageot S, Gagniere B (2009) A new knee arthrometer, the GNRB: experience in ACL complete and partial tears. Orthop Trauma 95:171–176

    CAS  Google Scholar 

  22. Schuster AJ, McNicholas MJ, Wachtl SW et al (2004) A new mechanical testing device for measuring anteroposterior knee laxity. Am J Sports Med 32(7):1731–1735

    Article  PubMed  Google Scholar 

  23. Stöhr A, Höll A, Bernstein A, Mayr HO (2009) Neue Quantifizierung der ap-Translation des Kniegelenkes unter Berücksichtigung der Rotationsstabilität. AGA-Kongress Leipzig, V2

  24. Tsai AG, Musahl V, Steckel H et al (2008) Rotational knee laxity: reliability of a simple measurement device in vivo. BMC Musculoskelet Disord 9:35

    Article  PubMed  Google Scholar 

  25. Un BS, Beynnon BD, Churchill DL et al (2001) A new device to measure knee laxity during weightbearing and non-weightbearing conditions. J Orthop Res 19:1185–1191

    Article  PubMed  Google Scholar 

  26. Woo SLY, Kanamori A, Zeminski J et al (2002) The effectiveness of reconstruction of the anterior cruciate ligament with hamstrings and patellar tendon. JBJS 84-A(6):907–914

    Google Scholar 

  27. Zantop T, Herbort M, Raschke MJ et al (2007) The role of the anteromedial and posterolateral bundles of the anterior cruciate ligament in anterior tibial translation and internal rotation. Am J Sports Med 35(2):223–227

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: er ist wissenschaftlicher Berater der Fa. ORTEMA GmbH, 71706 Markgröningen, Deutschland.

Author information

Authors and Affiliations

  1. Orthopädische Chirurgie München (OCM), Steinerstr. 6, 81369, München, Deutschland

    H.O. Mayr & A. Stöhr

Authors
  1. H.O. Mayr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Stöhr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H.O. Mayr.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mayr, H., Stöhr, A. Aktueller Stand der instrumentellen Messung der Knielaxität. Arthroskopie 23, 56–61 (2010). https://doi.org/10.1007/s00142-009-0546-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00142-009-0546-7

Schlüsselwörter

Keywords

Search

Navigation