Review article: Validity of the KT-1000 knee ligament arthrometer by ProQuest

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The KT-1000 knee arthrometer (KT-1000) is an objective instrument to measure anterior tibial motion relative to the femur for anterior cruciate ligament (ACL) reconstruction. Four studies between 1950 and 2007 regarding validity of the KT-1000 were identified using a Medline search. One had interpretable information on sensitivities, specificities, and predictive values to validate the instrument as a diagnostic tool in patients with acute or chronic ACL injuries. Three had limitations in methodology. We suggest that the KT-1000 should be used with caution as an objective instrument. Rather, using a KT-1000 score derived by subtracting the anterior tibial motion relative to the femur of the injured knee to that of the uninjured knee may be more appropriate as a dichotomous diagnostic test with a threshold of 2 or 3 mm. [PUBLICATION ABSTRACT]

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									Journal of Orthopaedic Surgery 2009;17(1):77-9




                         Review article:
            Validity of the KT-1000 knee ligament
                          arthrometer
                                                       S Arneja, J Leith
                  Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada




                                                                 INTRODUCTION

ABSTRACT                                                         The anterior cruciate ligament (ACL) is the primary
                                                                 restraint to anterior tibial motion in relation to the
The KT-1000 knee arthrometer (KT-1000) is an                     femur. ACL deficiency can be evaluated using clinical
objective instrument to measure anterior tibial                  tests (namely the anterior drawer test, Lachman test,
motion relative to the femur for anterior cruciate               and pivot shift test), magnetic resonance imaging,
ligament (ACL) reconstruction. Four studies between              arthroscopy, and arthrometric testing. Comparing
1950 and 2007 regarding validity of the KT-1000                  surgical outcomes using imaging modalities or
were identified using a Medline search. One had                  arthroscopy is not objective. Although clinical tests are
interpretable information on sensitivities, specificities,       useful for diagnosis and treatment, their interpretation
and predictive values to validate the instrument as a            can vary among clinicians.
diagnostic tool in patients with acute or chronic ACL                The KT-1000 knee arthrometer (KT-1000) is an
injuries. Three had limitations in methodology. We               objective instrument for ACL reconstruction, which
suggest that the KT-1000 should be used with caution             measures anterior tibial motion relative to the femur.
as an objective instrument. Rather, using a KT-1000              The test involves strapping the KT-1000 to the leg,
score derived by subtracting the anterior tibial motion          pulling the tibia anteriorly, and quantifying the amount
relative to the femur of the injured knee to that of             of movement in millimeters (mm). A KT-1000 score
the uninjured knee may be more appropriate as a                  is derived by subtracting the anterior tibial motion
dichotomous diagnostic test with a threshold of 2 or             relative to the femur of the injured knee to that of the
3 mm.                                                            uninjured knee. 15, 20, and 30 pounds (67, 89, and 133
                                                                 Newtons, respectively) of anterior displacement force
Key words: anterior cruciate ligament; arthrometry, articular;   are applied to the knee joint. The compliance index
reproducibility of results; review                               is the difference in anterior excursion between 15
                                                                 and 20 pounds of displacement forces, providing an




Address correspondence and reprint requests to: Dr Jordan Leith, Joint Preservation Centre of British Columbia, University of
British Columbia Hospital, 2nd Floor, Unit 2C, 2211 Wesbrook Mall, Vancouver
								
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