The American journal of sports medicine · 2008
Comparison of cutaneous and transosseous electromagnetic position sensors in the assessment of tibial rotation in a cadaveric model.
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Magit David P, McGarry Michelle, Tibone James E, Lee Thay Q
Аннотация
BACKGROUND: Recent studies have highlighted the growing interest in validating anatomic anterior cruciate ligament reconstructions. A simple method of measuring tibial rotation is necessary to provide an objective clinical assessment of restoration of normal knee kinematics after various anterior cruciate ligament reconstructive techniques.
OBJECTIVE: To validate a new method of measuring tibial rotation by comparing cutaneous with transosseous electromagnetic position sensors during a simulated standard knee examination.
STUDY DESIGN: Controlled laboratory study.
METHODS: Eight thawed, fresh-frozen cadaveric knee specimens with skin and soft tissues preserved were mounted on the femoral side in neutral rotation by a rigid clamp, allowing 6 degrees of freedom of the knee joint. With the knee fixed at 30 degrees of flexion, a series of maximal manual internal and external tibial rotations were performed and measured with an electromagnetic tracking system that measures 6 degrees of freedom in a Cartesian coordinate system. During each series of measurements, a cutaneous transmitter was fixed overlying the tibial tuberosity. Simultaneously, a second transducer was rigidly fixed to a trans-osseous pin placed just distal to the tibial tubercle. Measurements were repeated at 90 degrees of flexion. Differences in measurements were assessed.
RESULTS: No significant differences were found with maximal internal and external rotation between cutaneous and transosseous measurements at 30 degrees of knee flexion (13.0 degrees vs 14.5 degrees , P = .4) or at 90 degrees of flexion (11.2 degrees vs 12.9 degrees , P = .5). Correlation (R) between cutaneous and transosseous measurements at 30 degrees was .97 (P = .00009) and at 90 degrees was .99 (P < .00001). The accuracy of cutaneous measurements using transosseous as the known was 1.6 degrees +/- 1.3 degrees . Repeatability of cutaneous measurements was 0.8 degrees +/- 0.4 degrees . The repeatability of transosseous measurements was 1.0 degrees +/- 0.5 degrees .
CONCLUSION: No significant differences were found at either 30 degrees or 90 degrees of flexion when measuring tibial rotation using cutaneous versus transosseous electromagnetic position sensors.
CLINICAL RELEVANCE: The ability to measure knee rotation using cutaneous electromagnetic position sensors represents a promising new method for assessing various clinical conditions and surgical outcomes.
OBJECTIVE: To validate a new method of measuring tibial rotation by comparing cutaneous with transosseous electromagnetic position sensors during a simulated standard knee examination.
STUDY DESIGN: Controlled laboratory study.
METHODS: Eight thawed, fresh-frozen cadaveric knee specimens with skin and soft tissues preserved were mounted on the femoral side in neutral rotation by a rigid clamp, allowing 6 degrees of freedom of the knee joint. With the knee fixed at 30 degrees of flexion, a series of maximal manual internal and external tibial rotations were performed and measured with an electromagnetic tracking system that measures 6 degrees of freedom in a Cartesian coordinate system. During each series of measurements, a cutaneous transmitter was fixed overlying the tibial tuberosity. Simultaneously, a second transducer was rigidly fixed to a trans-osseous pin placed just distal to the tibial tubercle. Measurements were repeated at 90 degrees of flexion. Differences in measurements were assessed.
RESULTS: No significant differences were found with maximal internal and external rotation between cutaneous and transosseous measurements at 30 degrees of knee flexion (13.0 degrees vs 14.5 degrees , P = .4) or at 90 degrees of flexion (11.2 degrees vs 12.9 degrees , P = .5). Correlation (R) between cutaneous and transosseous measurements at 30 degrees was .97 (P = .00009) and at 90 degrees was .99 (P < .00001). The accuracy of cutaneous measurements using transosseous as the known was 1.6 degrees +/- 1.3 degrees . Repeatability of cutaneous measurements was 0.8 degrees +/- 0.4 degrees . The repeatability of transosseous measurements was 1.0 degrees +/- 0.5 degrees .
CONCLUSION: No significant differences were found at either 30 degrees or 90 degrees of flexion when measuring tibial rotation using cutaneous versus transosseous electromagnetic position sensors.
CLINICAL RELEVANCE: The ability to measure knee rotation using cutaneous electromagnetic position sensors represents a promising new method for assessing various clinical conditions and surgical outcomes.