The use of an electromagnetic measurement system for anterior tibial displacement during the Lachman test

Arthroscopy. 2011 Jun;27(6):792-802. doi: 10.1016/j.arthro.2011.01.012. Epub 2011 Apr 14.

Abstract

Purpose: The purpose of this study was to assess quantitative anterior/posterior values during the Lachman test by an electromagnetic measurement system and to compare data with KT-1000 arthrometric measurements (MEDmetric, San Diego, CA), as well as the measurement of radiologic laxity by dynamic radiographs.

Methods: We used an electromagnetic device to quantitatively evaluate anterior knee displacements. We tested 82 knees in 41 patients (30 isolated anterior cruciate ligament [ACL]-deficient, 11 ACL-reconstructed, and 41 contralateral ACL-intact knees). Anterior displacements during the Lachman test were calculated by the electromagnetic measurement system and fluoroscopic measurement, and anterior displacements were also measured by the KT-1000 arthrometer. Anterior/posterior displacements measured by these methods were compared, and correlations were assessed.

Results: In ACL-deficient knees, mean anterior/posterior displacement (±SE) was 22.4 ± 0.8 mm in electromagnetic measurements, 22.0 ± 0.7 mm in fluoroscopic measurements, and 15.0 ± 0.6 mm in KT-1000 measurements. In contralateral ACL-intact knees, it was 15.7 ± 0.6 mm, 15.6 ± 0.5 mm, and 9.9 ± 0.4 mm, respectively. In ACL-reconstructed knees, it was 15.7 ± 0.7 mm, 16.2 ± 0.8 mm, and 11.2 ± 0.6 mm, respectively. In all knee conditions, significant differences between fluoroscopic measurements and KT-1000 measurements were detected (P < .01). Significant differences were also detected between electromagnetic measurements and KT-1000 measurements (P < .01). No significant differences were detected between fluoroscopic measurements and electromagnetic measurements. A strong correlation was obtained between KT-1000 measurements and fluoroscopic measurements (r = 0.62, P < .01) and between electromagnetic measurements and KT-1000 measurements (r = 0.64, P < .01). However, the strongest correlation was observed between electromagnetic measurements and fluoroscopic measurements (r = 0.96, P < .01).

Conclusions: An electromagnetic measurement system to test anterior/posterior tibial translation determined that quantification of the Lachman test could be performed as accurately as fluoroscopic measurements.

Level of evidence: Level II, development of diagnostic criteria on basis of consecutive patients with universally applied reference gold standard.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Anterior Cruciate Ligament / physiopathology*
  • Anterior Cruciate Ligament Injuries
  • Arthroscopy
  • Diagnostic Techniques and Procedures / instrumentation*
  • Electromagnetic Fields*
  • Female
  • Follow-Up Studies
  • Humans
  • Joint Instability / diagnosis*
  • Joint Instability / physiopathology
  • Knee Injuries / diagnosis*
  • Knee Injuries / physiopathology
  • Knee Joint / physiopathology*
  • Male
  • Middle Aged
  • Physical Examination / methods
  • Prospective Studies
  • Range of Motion, Articular*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Time Factors
  • Trauma Severity Indices
  • Young Adult