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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 2/2020

01-02-2020 | Magnetic Resonance Imaging | KNEE

A new device for patellofemoral instrumented stress-testing provides good reliability and validity

Authors: Ana Leal, Renato Andrade, Betina B. Hinckel, Marc Tompkins, Paulo Flores, Filipe Silva, João Espregueira-Mendes, Elizabeth Arendt

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 2/2020

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Abstract

Purpose

To evaluate the reliability of an instrumented patellofemoral (PF) stress-testing—the Porto Patellofemoral Testing Device (PPTD)—and validate the instrumented assessment method comparing to manual physical examination.

Methods

Eight asymptomatic volunteers underwent bilateral PF-instrumented examination with the PPTD and magnetic resonance imaging (MRI) to assess intra-rater reliability of the instrumented assessment methodology. Six patients with unilateral PF instability underwent physical examination and PPTD concomitantly with MRI. Manual examination was performed by two blinded surgeons and compared with PPTD test. Ligament stiffness was calculated and compared between injured and non-injured lower limbs.

Results

PPTD showed a pre-determined and reproducible stress-force application with excellent intra-rater agreement (intra-class correlation coefficient 0.83–0.98). The manual exam was imprecise with variable examiner-dependent stress-force application. The PPTD resulted in greater lateral patellar translation (converted in quadrants) than manual exam for patients that have reached maximum translation force. Measurement of patellar position and displacement using PPTD was more accurate and precise than the visual estimation of translated quadrants by manual exam. Ligament stiffness curves showed no relevant changes in patellar displacement after 62 N.

Conclusion

The PPTD instrumented stress-testing is a valid device to quantify PF position and displacement with high intra-rater reliability, showing more accuracy, more precision and less variability than physical examination. This device provides an accurate and objective measure to quantify the patellar movement which can augment the physical examination procedures and assist clinicians in the management of decision-making and in the assessment of post-treatment outcomes of PF pathological conditions.
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Metadata
Title
A new device for patellofemoral instrumented stress-testing provides good reliability and validity
Authors
Ana Leal
Renato Andrade
Betina B. Hinckel
Marc Tompkins
Paulo Flores
Filipe Silva
João Espregueira-Mendes
Elizabeth Arendt
Publication date
01-02-2020
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 2/2020
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-019-05601-4

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