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Reliability of navigated knee stability examination: a cadaveric evaluation.
Andrew D Pearle1, Daniel J Solomon, Tony Wanich
1Hospital for Special Surgery, Sports Medicine and Shoulder Service, 535 East 70th Street, New York, NY 10021, USA. pearlea@hss.edu
The American Journal of Sports Medicine
|April 19, 2007
Summary
An image-free surgical navigation system accurately quantifies knee motion during stability tests. This technology precisely measures coupled knee movements, aiding in the diagnosis of complex rotatory instabilities.
Area of Science:
- Orthopedic surgery
- Biomechanics
- Medical imaging
Background:
- Clinical examination of knee instability can be subjective and challenging.
- Computerized navigation systems offer objective quantification of knee motion.
Purpose of the Study:
- To evaluate the reliability of an image-free navigation system for assessing multiplanar knee kinematics during stability testing.
- To compare the navigation system's measurements with a robotic system.
Main Methods:
- A controlled laboratory study using 6 cadaveric knees.
- Varus stress and combined varus/external rotation forces applied at different degrees.
- Testing performed on intact and sectioned posterolateral corner knees.
- Correlation analysis using intraclass correlation coefficient (ICC).
Main Results:
- High ICC values (overall 0.9976) indicated excellent agreement between the navigation system and robotic sensor.
- Statistically significant correlations for varus and external rotation at all tested angles (P < .01).
- Real-time visualization of coupled knee motions was achieved.
Conclusions:
- Image-free surgical navigation is a precise tool for quantifying knee stability.
- It can help identify complex multiplanar or coupled knee motions indicative of instability.
- The system may enhance the diagnostic evaluation of knee instability.
