The combination of radiostereometric analysis and the telos stress device results in poor precision for knee laxity measurements after anterior cruciate ligament reconstruction

O G Sørensen; K Larsen; B W Jakobsen; S Kold; T B Hansen; M Lind; K Søballe

doi:10.1007/s00167-010-1205-2

The combination of radiostereometric analysis and the telos stress device results in poor precision for knee laxity measurements after anterior cruciate ligament reconstruction

O G Sørensen, K Larsen, B W Jakobsen, S Kold, T B Hansen, M Lind, K Søballe

Research output: Contribution to journal › Journal article › Research › peer-review

11 Citations (Scopus)

Abstract

PURPOSE: Several devices for measuring knee laxity following anterior cruciate ligament ACL reconstruction exist, but the precision of the methods has never been optimal. Therefore, a new standardized protocol (NSP) was made, aiming at ensuring a reliable positioning of the Telos Stress Device (TSD) which theoretically could result in precise knee laxity measurements when using radiostereometric analysis (RSA) in combination with TSD.

METHOD: The TSD was applied to the knee of 30 healthy persons, using both the NSP and the official company instructions. The position of the stress arms of the TSD was marked following each measurement. The reliability of each protocol was calculated as the difference in length between the first and second markings. The NSP for the TSD was then used in a clinical study. Thirty-five patients underwent ACL reconstruction. Double measurements of knee laxity by RSA were performed at a 3-month follow-up.

RESULTS: Using the NSP for TSD positioning, the prediction interval at the marking sites ranged from ±0.4 to ±1.1 mm. Following the company instructions, the prediction interval ranged from ±0.8 to ±3.9 mm depending on marking site. Thus, the precision of positioning the stress arms of the TSD was improved at all marking sites using the NSP compared with the original company protocol. The double measurements of the knee laxity in the clinical study resulted in a mean difference of 0.0 mm and a prediction interval of ±5.2 mm.

CONCLUSION: Even though the NSP improved the positioning of the TSD on patients' extremities, the combination of NSP-TSD and RSA was not able to provide acceptable knee laxity measurements in a clinical setting compared with published precision data for other devices on the market. Therefore, the Telos Stress Device is not recommendable for use in knee laxity measurements following ACL reconstruction.

Original language	English
Journal	Knee Surgery, Sports Traumatology, Arthroscopy
Volume	19
Issue number	3
Pages (from-to)	355-62
Number of pages	8
ISSN	0942-2056
DOIs	https://doi.org/10.1007/s00167-010-1205-2
Publication status	Published - Mar 2011
Externally published	Yes

Keywords

Adult
Anterior Cruciate Ligament/surgery
Anterior Cruciate Ligament Injuries
Biomechanical Phenomena
Cohort Studies
Equipment Design
Female
Humans
Joint Instability/diagnosis
Knee Injuries/diagnostic imaging
Knee Joint/physiology
Male
Photogrammetry
Predictive Value of Tests
Radiography
Range of Motion, Articular/physiology
Reconstructive Surgical Procedures/instrumentation
Reference Values
Sensitivity and Specificity
Stress, Mechanical
Young Adult

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Sørensen, O. G., Larsen, K., Jakobsen, B. W., Kold, S., Hansen, T. B., Lind, M., & Søballe, K. (2011). The combination of radiostereometric analysis and the telos stress device results in poor precision for knee laxity measurements after anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy, 19(3), 355-62. https://doi.org/10.1007/s00167-010-1205-2

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title = "The combination of radiostereometric analysis and the telos stress device results in poor precision for knee laxity measurements after anterior cruciate ligament reconstruction",

abstract = "PURPOSE: Several devices for measuring knee laxity following anterior cruciate ligament ACL reconstruction exist, but the precision of the methods has never been optimal. Therefore, a new standardized protocol (NSP) was made, aiming at ensuring a reliable positioning of the Telos Stress Device (TSD) which theoretically could result in precise knee laxity measurements when using radiostereometric analysis (RSA) in combination with TSD.METHOD: The TSD was applied to the knee of 30 healthy persons, using both the NSP and the official company instructions. The position of the stress arms of the TSD was marked following each measurement. The reliability of each protocol was calculated as the difference in length between the first and second markings. The NSP for the TSD was then used in a clinical study. Thirty-five patients underwent ACL reconstruction. Double measurements of knee laxity by RSA were performed at a 3-month follow-up.RESULTS: Using the NSP for TSD positioning, the prediction interval at the marking sites ranged from ±0.4 to ±1.1 mm. Following the company instructions, the prediction interval ranged from ±0.8 to ±3.9 mm depending on marking site. Thus, the precision of positioning the stress arms of the TSD was improved at all marking sites using the NSP compared with the original company protocol. The double measurements of the knee laxity in the clinical study resulted in a mean difference of 0.0 mm and a prediction interval of ±5.2 mm.CONCLUSION: Even though the NSP improved the positioning of the TSD on patients' extremities, the combination of NSP-TSD and RSA was not able to provide acceptable knee laxity measurements in a clinical setting compared with published precision data for other devices on the market. Therefore, the Telos Stress Device is not recommendable for use in knee laxity measurements following ACL reconstruction.",

keywords = "Adult, Anterior Cruciate Ligament/surgery, Anterior Cruciate Ligament Injuries, Biomechanical Phenomena, Cohort Studies, Equipment Design, Female, Humans, Joint Instability/diagnosis, Knee Injuries/diagnostic imaging, Knee Joint/physiology, Male, Photogrammetry, Predictive Value of Tests, Radiography, Range of Motion, Articular/physiology, Reconstructive Surgical Procedures/instrumentation, Reference Values, Sensitivity and Specificity, Stress, Mechanical, Young Adult",

author = "S{\o}rensen, {O G} and K Larsen and Jakobsen, {B W} and S Kold and Hansen, {T B} and M Lind and K S{\o}balle",

year = "2011",

month = mar,

doi = "10.1007/s00167-010-1205-2",

language = "English",

volume = "19",

pages = "355--62",

journal = "Knee Surgery, Sports Traumatology, Arthroscopy",

issn = "0942-2056",

publisher = "Physica-Verlag",

number = "3",

}

Sørensen, OG, Larsen, K, Jakobsen, BW, Kold, S, Hansen, TB, Lind, M & Søballe, K 2011, 'The combination of radiostereometric analysis and the telos stress device results in poor precision for knee laxity measurements after anterior cruciate ligament reconstruction', Knee Surgery, Sports Traumatology, Arthroscopy, vol. 19, no. 3, pp. 355-62. https://doi.org/10.1007/s00167-010-1205-2

The combination of radiostereometric analysis and the telos stress device results in poor precision for knee laxity measurements after anterior cruciate ligament reconstruction. / Sørensen, O G; Larsen, K; Jakobsen, B W et al.
In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 19, No. 3, 03.2011, p. 355-62.

Research output: Contribution to journal › Journal article › Research › peer-review

TY - JOUR

T1 - The combination of radiostereometric analysis and the telos stress device results in poor precision for knee laxity measurements after anterior cruciate ligament reconstruction

AU - Sørensen, O G

AU - Larsen, K

AU - Jakobsen, B W

AU - Kold, S

AU - Hansen, T B

AU - Lind, M

AU - Søballe, K

PY - 2011/3

Y1 - 2011/3

N2 - PURPOSE: Several devices for measuring knee laxity following anterior cruciate ligament ACL reconstruction exist, but the precision of the methods has never been optimal. Therefore, a new standardized protocol (NSP) was made, aiming at ensuring a reliable positioning of the Telos Stress Device (TSD) which theoretically could result in precise knee laxity measurements when using radiostereometric analysis (RSA) in combination with TSD.METHOD: The TSD was applied to the knee of 30 healthy persons, using both the NSP and the official company instructions. The position of the stress arms of the TSD was marked following each measurement. The reliability of each protocol was calculated as the difference in length between the first and second markings. The NSP for the TSD was then used in a clinical study. Thirty-five patients underwent ACL reconstruction. Double measurements of knee laxity by RSA were performed at a 3-month follow-up.RESULTS: Using the NSP for TSD positioning, the prediction interval at the marking sites ranged from ±0.4 to ±1.1 mm. Following the company instructions, the prediction interval ranged from ±0.8 to ±3.9 mm depending on marking site. Thus, the precision of positioning the stress arms of the TSD was improved at all marking sites using the NSP compared with the original company protocol. The double measurements of the knee laxity in the clinical study resulted in a mean difference of 0.0 mm and a prediction interval of ±5.2 mm.CONCLUSION: Even though the NSP improved the positioning of the TSD on patients' extremities, the combination of NSP-TSD and RSA was not able to provide acceptable knee laxity measurements in a clinical setting compared with published precision data for other devices on the market. Therefore, the Telos Stress Device is not recommendable for use in knee laxity measurements following ACL reconstruction.

AB - PURPOSE: Several devices for measuring knee laxity following anterior cruciate ligament ACL reconstruction exist, but the precision of the methods has never been optimal. Therefore, a new standardized protocol (NSP) was made, aiming at ensuring a reliable positioning of the Telos Stress Device (TSD) which theoretically could result in precise knee laxity measurements when using radiostereometric analysis (RSA) in combination with TSD.METHOD: The TSD was applied to the knee of 30 healthy persons, using both the NSP and the official company instructions. The position of the stress arms of the TSD was marked following each measurement. The reliability of each protocol was calculated as the difference in length between the first and second markings. The NSP for the TSD was then used in a clinical study. Thirty-five patients underwent ACL reconstruction. Double measurements of knee laxity by RSA were performed at a 3-month follow-up.RESULTS: Using the NSP for TSD positioning, the prediction interval at the marking sites ranged from ±0.4 to ±1.1 mm. Following the company instructions, the prediction interval ranged from ±0.8 to ±3.9 mm depending on marking site. Thus, the precision of positioning the stress arms of the TSD was improved at all marking sites using the NSP compared with the original company protocol. The double measurements of the knee laxity in the clinical study resulted in a mean difference of 0.0 mm and a prediction interval of ±5.2 mm.CONCLUSION: Even though the NSP improved the positioning of the TSD on patients' extremities, the combination of NSP-TSD and RSA was not able to provide acceptable knee laxity measurements in a clinical setting compared with published precision data for other devices on the market. Therefore, the Telos Stress Device is not recommendable for use in knee laxity measurements following ACL reconstruction.

KW - Adult

KW - Anterior Cruciate Ligament/surgery

KW - Anterior Cruciate Ligament Injuries

KW - Biomechanical Phenomena

KW - Cohort Studies

KW - Equipment Design

KW - Female

KW - Humans

KW - Joint Instability/diagnosis

KW - Knee Injuries/diagnostic imaging

KW - Knee Joint/physiology

KW - Male

KW - Photogrammetry

KW - Predictive Value of Tests

KW - Radiography

KW - Range of Motion, Articular/physiology

KW - Reconstructive Surgical Procedures/instrumentation

KW - Reference Values

KW - Sensitivity and Specificity

KW - Stress, Mechanical

KW - Young Adult

U2 - 10.1007/s00167-010-1205-2

DO - 10.1007/s00167-010-1205-2

M3 - Journal article

C2 - 20680246

SN - 0942-2056

VL - 19

SP - 355

EP - 362

JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

IS - 3

ER -

The combination of radiostereometric analysis and the telos stress device results in poor precision for knee laxity measurements after anterior cruciate ligament reconstruction

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