Radiographic assessment of sagittal knee instability in weight bearing. A study on anterior cruciate-deficient knees

In 16 patients with chronic, symptomatic anterior cruciate ligament-deficient knees, sagittal displacement was studied in the standing position using fluoroscopic control and a simple device to support the knee. In slight weight bearing all knees but one had normal femorotibial alignment in the lateral view. During full weight bearing sagittal displacements between 2 mm and 17 mm were recorded in 14 patients. The largest displacements were obtained at different angles of inclination of the leg and flexion of the knee joint and were independent of the point of support of the knee joint. The reproducibility of this new standing technique was within 2 mm. A high correlation with previous methods of radiographic measurements of sagittal laxity was found. By the use of the normal relationship between the tibial eminence and the femoral condyles it is possible to record and measure sagittal displacements on a single lateral radiograph of the standing knee joint.