Michel Collette • Julie Courville • Marc Forton • Bertrand Gagnière - 29 December 2011

Abstract

Purpose Accurate measurement of laxity after anterior cruciate ligament (ACL) rupture is usually performed with the KT-1000 arthrometer, and reproducibility and reliability are discussed. A new arthrometer, the GNRB®, has
been recently developed in an attempt to improve intraand inter-examiner reproducibility. The aim of this diagnostic study was to evaluate the intra- and inter-examiner reproducibility of the GNRB® and the KT-1000. Methods Three protocols were designed to evaluate and compare the two arthrometers. Fifteen physiotherapists conducted tests on 15 subjects with healthy knees. The intra- and inter-reproducibility of the two tests were compared by analysis of variance and the F-test. Results Measure reproducibility was significantly worst with the KT-1000 than with the GNRB® (machine effect, P\0.001) regardless of operator experience. There was no significant difference between experienced and inexperienced examiners with the GNRB® (no ‘examiners effect’). Regardless of the machine, there was a ‘side effect’ with healthy knees. Conclusion This clinical study demonstrates the superior intra- and inter-examiner reproducibility of the GNRB® over the KT-1000. There appears to be some technological
advantages to using the GNRB® including pressure control of the patella, accuracy of the displacement transducer, control of the load on the calf, and control of hamstring activity.

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Abstract SFA 2011

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Reliability of the GNRB for measuring anterior knee laxity: comparison with Telos in 114 knees

N LEFEVRE, Y BOHU, JF NAOURI, S HERMAN. Paris

Introdcution:

Clinical diagnosis of anterior cruciate ligament (ACL) tears by the Lachman Test or Pivot shift test are reliable. Nevertheless, the quantitative assessment of the anterior tibial translation (KT-1000 arthrometer or radiologic Telos) is necessary to evaluated each patient. During the past year, we have been using the GNRB system, an alternative anterior knee laxity measurement device. We hypothesize that this knee laxity measurement device is more reliable and reproducible than other currently available arthrometers.
Materiel and methods:
A prospective study has been realized in order to evaluate the reliability and the sensibility of the GNRB measures before arthroscopic reconstruction of the ACL. Between the beginning of 2011 and end of June, 114 patients have been operated for a ACL tear by patellar graft tendon or hamstring graft tendon technique. For each patient, GNRB comparatives measures have been done before the operation. The GNRB was compared to the radiologic telos. Only were included patients with a contralateral healthy knee. All patients had an intra-articular reconstruction either complete (92 cases) or partial (22cases).

This study is availble just in French.

What confirmation for clinical diagnosis of ACL tears?

Dr MH Binet

Knee ACL tears are a common ski injury. The first diagnosis is made by the hand of the physician. More experienced is the practitioner, more ACL tears are clinically found out. But with the increasing numbers of old injuries, of partial tears of the ACL, of associated lesions, the diagnosis is not always clear after the clinical tests.

The other exams currently made in the emergency rooms are X Rays. We know that the radiography do not bring often useful information except the classic “Segond’s fracture”. The gold standard is the MRI which is not available in the medical centres of the ski resorts.

A new device called Genou Rob is presented. This machine is able to measure the tibial plateau movement when applied different loads. The mobility is measured in mm comparatively to the non-injured knee. When the difference between the curves is larger than 2.8 mm and when the curves inclination is different, the ACL is supposed to be torn; when the difference is larger than 2 mm and if the curves inclination is not different, the ACL is supposed to be partially torn.

This study is just availble in French.

This study is just available in French

The translation is just available in French

The translation is just available in French