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Objective To compare Magnetic Resonance Imaging(MRI) and stress radiography in diagnosing chronic anterior talofibular ligament (ATFL) injury.Methods Among 45 patients undergoing ankle arthroseopy between October 2016 and December 2016,39 patients were included in this study.The ankle arthroscopy was used as the gold standard for diagnosing the chronic ATFL injury.The sensitivity,speciality and accuary of MRI and stress radiography were calculated according to the arthroscopic findings.Results The ankle arthroscopy revealed ATFL injury in 30 cases and intact ATFL in 9 cases,while MRI results found ATFL injury in 28 cases and intact ATFL in 11 cases with thesensitivity,speciality and accuary of 90.0％,88.9％ and 89.7％ respectively.The stress radiography results revealed ATFL injury in 21 cases and intact ATFL in 18 cases,with the sensitivity,speciality and accuary of 63.3％,77.8％ and 66.7％.Conclusion MRI was more reliable in diagnosing chronic ATFL injury compared with the stress radiography.
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PURPOSE: The purpose of this study is to examine the clinical applicability of stress radiography in patients presenting with shoulder instability. MATERIALS AND METHODS: Fifty-six patients diagnosed with shoulder instability and 20 healthy volunteers participated in the study. Degree of displacement of the humeral head as measured on stress radiography using a Telos GA-IIE device was compared with the results of the physical examinations. Four types of stress radiography were captured while applying 15 daN of force anteriorly (AER0 and AER60) and posteriorly (PER0 and PER60) at two different positions: (1) 90° of abduction combined with 0° of external rotation, and (2) 90° of abduction combined with 60° of external rotation. RESULTS: The degree of displacement of affected shoulders of 44 patients showed significantly larger displacement than normal shoulders (p<0.05), and the comparison between 56 affected shoulders of the patients and 40 normal shoulders of the volunteers showed significantly larger displacement only in PER0 and PER60 of the patients (p<0.05). Among the four radiographs of affected shoulders, AER60 showed significantly less displacement (p=0.046). The anterior drawer test under anesthesia of 16 patients who underwent surgery for anterior instability showed positive correlation with AER0 (Spearman's rho=0.56, p<0.024). Significantly larger anterior displacement of the load and shift test was observed in the subgroup with anterior displacement more than 3 mm (p=0.028), and higher positive frequency of the Kim's test was observed in the subgroup with posterior displacement more than 3 mm (p=0.005). CONCLUSION: Stress radiography using a Telos GA-IIE device could discriminate the affected shoulder. Although it could not replace individual physical examinations, the degree of displacement correlates with some physical examinations for shoulder instability.
Subject(s)
Humans , Anesthesia , Healthy Volunteers , Humeral Head , Physical Examination , Radiography , Shoulder , VolunteersABSTRACT
Objective Stress radiography provides an objective tool to measure posterior knee instability.This study was conducted to evaluate the intraobserver and interobserver reliability of measurements using Telos device to quantify posterior knee instability,compared wim KT-1000 and PDT test for consistency analysis.Methods From October 2008 to June 2009,68 stress radiographs in 34 patients with posterior knee instability were taken using Telos device.The amount of posterior displacement on the radiographs was measured independently by 2 surgeons on 2 separate occasions.Changes in intraclass correlation coefficients(ICCs)were examined to assess the intraobserver and interobserver reliability of the measurement,and were compared with those from KT-1000 and PDT test for consistency analysis.Results Intraobserver ICC was 0.992,while interobserver ICC Was 0.991.There was no significant difierence between Telos and KT-1000 in pair-t test.The data from Telos device was consistent with KT-1000.The coincident ratio Of PDT test was 20% while the posterior displacement of the tibia calculated on stress radiography was 5-10 mm.The coincident ratio of the PDT was 71.4% while the posterior displacement of the tibia calculatcd from stress radiography was 10-15 mm.Conclusion Using Telos device for stress radiograph provides a reproducible method to quantify posterior knee instability,and the consistency between Telos divece and KT-1000 was reliable.The coincident ratio of the PDT test with stress radiography increased when the posterior displacement of the tibia from stress view became more severe.
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PURPOSE: We analyzed the correlation of the Lysholm score, anterior displacement of tibia on stress radiography and muscle strength around the knee with postural control after anterior cruciate ligament reconstruction and also compared them with the normal subjects. MATERIALS AND METHODS: Twenty-five patients after ACL reconstruction were evaluated with Lysholm knee score, anterior displacement on stress radiography with Telos, muscle strength around the knee with Biodex dynamometer and postural control with posturography. RESULTS: The postural control had significant correlation with the Lysholm knee score & anterior displacement on stress radiography(r=0.565, r=0.783, p0.05). Patients group with 5mm instability under anterior displacement on stress radiography showed no significance compared with normal control group, while the group with instability more than 6mm showed significant differences in some conditions com- pared with control group. CONCLUSION: Postural control after ACL reconstruction have significant correlation with Lysholm score and we presumed that the acquisition of mechanical stability of the knee after ACL reconstruction may be one of the important factors associated with the recovery of postural control by improvement of the proprioception.