Quantitative Measurement of Rotational Knee Stability: A Systematic Review of Instrument Reliability and Validity.

Area of Science:

• Orthopedics
• Biomechanics
• Sports Medicine

Background:

• Objective evaluation of knee stability in multiple planes offers comprehensive data for anterior cruciate ligament (ACL) injury management.
• Reliability and validity are crucial for assessing the clinical utility of instruments measuring knee stability.
• Existing instruments for rotational knee stability lack clear evidence of adequate reliability and validity.

Purpose of the Study:

• To systematically review instruments measuring rotational knee stability.
• To synthesize existing literature on the reliability and validity of these instruments.

Main Methods:

• A systematic literature search was conducted across four databases.
• Publications reporting reliability or validity of rotational knee stability instruments were included.
• A narrative synthesis approach was used to present findings.

Main Results:

• Twenty-five different instruments were evaluated across 42 studies.
• High heterogeneity was observed in reported parameters and criterion methods.
• Intrarater and interrater reliability were generally adequate (> .75), except under specific conditions (low torque, acceleration/jerk measurement).
• Only 21.1% of validity studies reported very good correlations (r > .8) with criterion measures.

Conclusions:

• No instrument demonstrated sufficient high-quality evidence for both reliability and validity.
• Further research and development are necessary to create and validate devices for objective, multi-planar knee stability assessment.