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Related Experiment Videos

Measuring flexion in knee arthroplasty patients.

John Z Edwards1, Kenneth A Greene, Robert S Davis

  • 1Walter A. Hoyt, Jr. Musculoskeletal Research Laboratory, Department of Orthopaedic Surgery, Summa Health System, Akron, Ohio, USA.

The Journal of Arthroplasty
|April 7, 2004
PubMed
Summary

Visual estimation and goniometer measurements of knee flexion after total knee arthroplasty are often inaccurate, especially at higher flexion angles. Radiographic measurement remains the most reliable method for assessing total knee arthroplasty outcomes.

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Area of Science:

  • Orthopedics
  • Biomedical Engineering
  • Radiology

Background:

  • Accurate measurement of knee flexion is crucial for evaluating outcomes after total knee arthroplasty (TKA).
  • Current methods include visual estimation, goniometry, and radiographic analysis.
  • The reliability and accuracy of non-radiographic methods require further investigation.

Purpose of the Study:

  • To compare the accuracy of visual estimation and goniometric measurement of knee flexion against radiographic assessment following total knee arthroplasty.
  • To evaluate the influence of flexion angle and body mass index on measurement accuracy.

Main Methods:

  • Three blinded examiners visually estimated and goniometrically measured maximal knee flexion in 27 knees from 16 patients.
  • Lateral knee radiographs were obtained, and flexion angles were measured using two radiographic techniques.

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  • Interobserver and intraobserver reliability were assessed using correlation coefficients.

    • Main Results:

    • High interobserver (0.79) and intraobserver (0.92) reliability were found for goniometric measurements.
    • However, 45% of visual estimates and 22% of goniometric measurements deviated by 5 degrees or more from radiographic measurements.
    • Measurement discrepancies increased with greater knee flexion angles.
    • Body mass index did not significantly impact the accuracy of visual or goniometric measurements.

    Conclusions:

    • Visual estimation and goniometry demonstrate significant inaccuracies in measuring knee flexion post-TKA compared to radiographic methods.
    • The accuracy of these clinical methods decreases as knee flexion increases.
    • Radiographic assessment is recommended for precise evaluation of knee flexion after total knee arthroplasty.