Intraobserver and Interobserver Reliability of the Kneeling Technique of Stress Radiography for the Evaluation of Posterior Knee Laxity

Background: Stress radiography provides an objective tool to measure posterior knee instability. Intraobserver and interobserver reliability has been reported for the Telos device, but it has not been studied using the kneeling technique. Purpose: This study was conducted to evaluate the intraobserv...

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Veröffentlicht in:The American journal of sports medicine 2008-08, Vol.36 (8), p.1571-1576
Hauptverfasser: Jackman, Todd, LaPrade, Robert F., Pontinen, Thomas, Lender, Paul A.
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container_end_page 1576
container_issue 8
container_start_page 1571
container_title The American journal of sports medicine
container_volume 36
creator Jackman, Todd
LaPrade, Robert F.
Pontinen, Thomas
Lender, Paul A.
description Background: Stress radiography provides an objective tool to measure posterior knee instability. Intraobserver and interobserver reliability has been reported for the Telos device, but it has not been studied using the kneeling technique. Purpose: This study was conducted to evaluate the intraobserver and interobserver reliability of measurements made using kneeling stress radiography to quantify posterior knee instability. Study Design: Case series (diagnosis); Level of evidence, 4. Methods: One hundred thirty-two stress radiographs in 44 patients with suspected posterior knee instability were prospectively taken using the kneeling technique. The amount of posterior displacement on the radiographs was then measured independently by 3 blinded testers (an orthopaedic sports medicine faculty member, an orthopaedic chief resident, and a medical student) on 2 separate occasions. Changes in mean and intraclass correlation coefficients (ICCs) were examined to assess the intraobserver and interobserver reliability of the measurements. Results: Intraobserver changes in displacement means were small (−0.307 mm, −0.294 mm, and +0.035 mm) and only significant for observer 1. The combined intraobserver ICC was 0.973 for the 3 observers (0.976, 0.959, and 0.981). Interobserver comparisons revealed significant differences in trial 1 between observers 2 and 3 (0.675 mm), no differences in trial 2, and significant differences between observers 1 and 2 (0.333 mm) and observers 2 and 3 (0.510 mm) in the combined trial data. The combined interobserver ICC was 0.955 for the 3 observers (0.959 and 0.951 for the 2 trials). Conclusions: The kneeling technique for posterior cruciate ligament stress radiography provides a reproducible method to quantify posterior knee instability. Keywords: stress radiography posterior knee instability posterior cruciate ligament
doi_str_mv 10.1177/0363546508315897
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Intraobserver and interobserver reliability has been reported for the Telos device, but it has not been studied using the kneeling technique. Purpose: This study was conducted to evaluate the intraobserver and interobserver reliability of measurements made using kneeling stress radiography to quantify posterior knee instability. Study Design: Case series (diagnosis); Level of evidence, 4. Methods: One hundred thirty-two stress radiographs in 44 patients with suspected posterior knee instability were prospectively taken using the kneeling technique. The amount of posterior displacement on the radiographs was then measured independently by 3 blinded testers (an orthopaedic sports medicine faculty member, an orthopaedic chief resident, and a medical student) on 2 separate occasions. Changes in mean and intraclass correlation coefficients (ICCs) were examined to assess the intraobserver and interobserver reliability of the measurements. Results: Intraobserver changes in displacement means were small (−0.307 mm, −0.294 mm, and +0.035 mm) and only significant for observer 1. The combined intraobserver ICC was 0.973 for the 3 observers (0.976, 0.959, and 0.981). Interobserver comparisons revealed significant differences in trial 1 between observers 2 and 3 (0.675 mm), no differences in trial 2, and significant differences between observers 1 and 2 (0.333 mm) and observers 2 and 3 (0.510 mm) in the combined trial data. The combined interobserver ICC was 0.955 for the 3 observers (0.959 and 0.951 for the 2 trials). Conclusions: The kneeling technique for posterior cruciate ligament stress radiography provides a reproducible method to quantify posterior knee instability. 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Intraobserver and interobserver reliability has been reported for the Telos device, but it has not been studied using the kneeling technique. Purpose: This study was conducted to evaluate the intraobserver and interobserver reliability of measurements made using kneeling stress radiography to quantify posterior knee instability. Study Design: Case series (diagnosis); Level of evidence, 4. Methods: One hundred thirty-two stress radiographs in 44 patients with suspected posterior knee instability were prospectively taken using the kneeling technique. The amount of posterior displacement on the radiographs was then measured independently by 3 blinded testers (an orthopaedic sports medicine faculty member, an orthopaedic chief resident, and a medical student) on 2 separate occasions. Changes in mean and intraclass correlation coefficients (ICCs) were examined to assess the intraobserver and interobserver reliability of the measurements. Results: Intraobserver changes in displacement means were small (−0.307 mm, −0.294 mm, and +0.035 mm) and only significant for observer 1. The combined intraobserver ICC was 0.973 for the 3 observers (0.976, 0.959, and 0.981). Interobserver comparisons revealed significant differences in trial 1 between observers 2 and 3 (0.675 mm), no differences in trial 2, and significant differences between observers 1 and 2 (0.333 mm) and observers 2 and 3 (0.510 mm) in the combined trial data. The combined interobserver ICC was 0.955 for the 3 observers (0.959 and 0.951 for the 2 trials). Conclusions: The kneeling technique for posterior cruciate ligament stress radiography provides a reproducible method to quantify posterior knee instability. 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Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jackman, Todd</au><au>LaPrade, Robert F.</au><au>Pontinen, Thomas</au><au>Lender, Paul A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intraobserver and Interobserver Reliability of the Kneeling Technique of Stress Radiography for the Evaluation of Posterior Knee Laxity</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2008-08-01</date><risdate>2008</risdate><volume>36</volume><issue>8</issue><spage>1571</spage><epage>1576</epage><pages>1571-1576</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background: Stress radiography provides an objective tool to measure posterior knee instability. Intraobserver and interobserver reliability has been reported for the Telos device, but it has not been studied using the kneeling technique. Purpose: This study was conducted to evaluate the intraobserver and interobserver reliability of measurements made using kneeling stress radiography to quantify posterior knee instability. Study Design: Case series (diagnosis); Level of evidence, 4. Methods: One hundred thirty-two stress radiographs in 44 patients with suspected posterior knee instability were prospectively taken using the kneeling technique. The amount of posterior displacement on the radiographs was then measured independently by 3 blinded testers (an orthopaedic sports medicine faculty member, an orthopaedic chief resident, and a medical student) on 2 separate occasions. Changes in mean and intraclass correlation coefficients (ICCs) were examined to assess the intraobserver and interobserver reliability of the measurements. Results: Intraobserver changes in displacement means were small (−0.307 mm, −0.294 mm, and +0.035 mm) and only significant for observer 1. The combined intraobserver ICC was 0.973 for the 3 observers (0.976, 0.959, and 0.981). Interobserver comparisons revealed significant differences in trial 1 between observers 2 and 3 (0.675 mm), no differences in trial 2, and significant differences between observers 1 and 2 (0.333 mm) and observers 2 and 3 (0.510 mm) in the combined trial data. The combined interobserver ICC was 0.955 for the 3 observers (0.959 and 0.951 for the 2 trials). Conclusions: The kneeling technique for posterior cruciate ligament stress radiography provides a reproducible method to quantify posterior knee instability. Keywords: stress radiography posterior knee instability posterior cruciate ligament</abstract><cop>Los Angeles, CA</cop><pub>American Orthopaedic Society for Sports Medicine</pub><pmid>18448580</pmid><doi>10.1177/0363546508315897</doi><tpages>6</tpages></addata></record>
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ispartof The American journal of sports medicine, 2008-08, Vol.36 (8), p.1571-1576
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source MEDLINE; SAGE Complete A-Z List; Alma/SFX Local Collection
subjects Adolescent
Adult
Aged
Biological and medical sciences
Diagnosis
Diseases of the osteoarticular system
Health aspects
Humans
Joint Instability - diagnostic imaging
Knee
Knee joint
Knee Joint - physiology
Medical sciences
Medical students
Medical treatment
Methods
Middle Aged
Musculoskeletal tests
Observer Variation
Posterior Cruciate Ligament
Posture
Prospective Studies
Radiography
Radiography - instrumentation
Reproducibility of Results
Sports medicine
Stress fractures
Stress, Mechanical
Studies
title Intraobserver and Interobserver Reliability of the Kneeling Technique of Stress Radiography for the Evaluation of Posterior Knee Laxity
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